人工周期冻融胚胎移植妊娠结局影响因素分析  

Analysis of Factors Influencing the Results of Frozen Embryo Transfer(FET) Treated with Hormone Replacement

作　　者：龚梦[1] 明蕾[1] 李春燕[1] 项燕[1] 

机构地区：[1]武汉大学人民医院生殖中心,武汉430000

出　　处：《临床误诊误治》2015年第6期93-96,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨影响采用人工周期准备内膜冻融胚胎移植(frozen embryo transfer,FET)妊娠结局的相关因素,以期为临床提高FET妊娠率提供一定的指导。方法回顾分析武汉大学人民医院生殖中心2011年1月—2014年12月按人工周期准备内膜行FET的930例的临床资料,受精方式包括体外受精(IVF)和卵胞浆内单精子注射(ICSI),采用阴道B超监测内膜厚度,记录人工周期准备内膜行冻融胚胎移植的不孕妇女决定移植日血清雌二醇(E2)、孕酮(P)水平,并计算E2/P比值,分析不孕原因、不孕年限、年龄、促排卵用药方案、受精方式、内膜厚度、优质胚胎数、E2、P及E2/P等与FET临床妊娠结局的关系,并进一步采用多因素logistic回归模型分析影响妊娠结局的相关因素。结果不孕年限、年龄、子宫内膜厚度、P水平、E2/P及优质胚胎数与临床妊娠结局有一定相关性(P<0.05,P<0.01);logistic回归分析显示,年龄、子宫内膜厚度、E2/P为临床妊娠结局的影响因素(P<0.05,P<0.01)。结论对采用人工周期准备内膜行FET的患者重点调控子宫内膜厚度、E2/P可提高临床妊娠率;筛选适龄患者亦是提高妊娠率的重要手段。Objective To explore the influencing factors of the pregnancy outcome of the frozen embryo transfer in ar-tificial cycles. Methods A retrospective analysis was performed for clinical data of 930 cases undergoing frozen embryo trans-fer treatment during Jan. 2011 and Dec. 2014. All patients accepted hormone replacement therapy. Endometrial thickness was monitored by transvaginal ultrasound. Estrogen （ E2 ） and progesterone （ P） level as well as E2/P ratio were recorded. Infertil-ity factors, time, age, ovulation induction regimen, insemination, endometrial thickness, E2 level, P level and E2/P ratio and their relation with the clinical pregnancy outcomes were analyzed. In addition, the multivariate Logistic Regression model was used to investigate the related factors affecting pregnancy outcome FET. Results Infertility time, age, endometrial thickness, P level, E2/P ratio and good quality embryo had a relationship with clinical pregnancy outcomes（P〈0. 05,P〈0. 01）. Multi-variate logistic regression analysis showed that age, endometrial thickness and E2/P ratio could affect clinical pregnancy out-comes（P〈0. 05,P〈0. 01）. Conclusion Regulating endometrial thickness, E2/ P ratio factors can improve clinical preg-nancy rate for patients undergoing FET in artificial cycle. Screening patients of suitable age is also an important means to im-prove the pregnancy rate.

关 键 词：人工周期 冻融胚胎移植 影响因素 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]