影响月经规律患者冻融胚胎移植结局相关因素分析  

Analysis of factors influencing the results of frozen-thawed embryo transfer for patients with menstrual regularity

作　　者：李红芳[1] 李豫峰[2] 

机构地区：[1]洛阳市妇女儿童医疗保健中心生殖医学研究所,河南洛阳471000 [2]华中科技大学同济医学院附属同济医院生殖中心,湖北武汉430030

出　　处：《中国优生与遗传杂志》2014年第7期139-142,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨影响月经规律患者冻融胚胎移植妊娠的相关因素。方法对同济医院生殖中心2011年12月至2012年8月行冻融胚胎复苏移植周期的月经规律患者进行回顾性分析,共1279个周期,比较不同年龄、不孕年限、移植次数、胚胎情况、内膜准备方法等对临床结局的影响。结果 1、年龄:随着年龄递增,胚胎着床率、临床妊娠率下降,>35岁组明显低于≤35岁组(P<0.05)。2、不孕年限:随着不孕年限递增,胚胎着床率、临床妊娠率下降,>5年组明显低于≤5年组。3、移植次数:随着移植次数增加,优胚率下降,胚胎着床率、临床妊娠率下降。4、移植胚胎个数:着床率3个组最低(P<0.05);临床妊娠率、流产率2个组最高(P<0.05)。5、移植优质胚胎个数:胚胎着床率、临床妊娠率、流产率2个组最高,3个组最低(P<0.05)。6、胚龄:D5胚胎着床率、临床妊娠率最高。7、内膜厚度:<8mm组和≥8mm组两组间比较胚胎着床率、临床妊娠率、流产率、宫外孕率差异无统计学差异(P>0.05)。8、内膜准备方法:胚胎着床率、临床妊娠率激素替代周期组最高,自然周期组最低。9、临床妊娠相关因素的logistics回归分析结果显示:患者年龄、不孕年限、移植次数与妊娠负相关,移植优质胚胎个数、胚龄与妊娠正相关,但均无显著相关(P>0.05)。结论 1、年龄、不孕年限是影响冻融胚胎移植成功的重要因素,提倡对不孕症早诊断、早治疗,不延误病情。2胚胎情况是影响冻融胚胎移植成功的关键因素,移植3个胚胎并不能提高成功率,建议移植1-2个胚胎,囊胚移植明显提高成功率。3、激素替代是一种较好的内膜准备方法,芬吗通有好的应用前景,但有待更多病例的积累。Objective： To analyze factors influencing the results of frozen-thawed embryo transfer （FET） of patients with menstrual regularity. Methods： A retrospective study was conducted in 1279 FET cycles of patients with menstrual regularity in Wuhan Tongji Reproductive Medicine Center between December 2011 and Auguest 2012. Groups were divided according to patients＇ age, duration of infertility, number of transplantation, condition of embryos, ways preparing for endomerium. The pregnancy outcome was compared during these groups. Results： Logistics regression analysis of clinical pregnancy-associated factors showed that： The age of female patients, infertile duration, number of transferred good quality embryos and embryo age were significantly correlated to clinical pregnancy. Endometrial thickness was no significant correlation with clinical pregnancy. Conclusions： 1. Among the tested factors, the age of female patients, infertile duration, number of transferred good quality embryos and embryo age were important factors in the success of frozen-thawed embryo transfer （FET） of patients with menstrual regularity. 2. Condition of embryo was significant correlation with success of frozen-thawed embryo transfer （FET） of patients with menstrual regularity. Increasing the number of transferred embryos wash＇ t able to improve success rate, maybe the better chose is to transfer 1-2 embryos. Blastocyst transfer could improve success rate obviously. 3. Endomerial preparation with estrogen could improve success rate significantly, maybe it is a better method for endometrial preparation of frozen-thawed embryo transfer （FET） of patients with menstrual regularity. Adding Femonston could improve success rate, maybe it has a good future. Further studies are still needed.

关 键 词：月经规律 冻融胚胎 子宫内膜 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]