冻融胚胎与新鲜胚胎移植的新生儿结局比较  

Comparison of neonatal outcomes between frozen-thawed embryo transfer and fresh embryo transfer

作　　者：周晶[1] 李博[1] 陈书强[1] 黄剑磊[1] 李丽[1] 刘闯[1] 何玉萍[1] 王晓红[1] 

机构地区：[1]第四军医大学唐都医院生殖医学中心,西安710038

出　　处：《生殖医学杂志》2017年第1期9-13,共5页Journal of Reproductive Medicine

基　　金：国家自然科学基金面上项目(81370710)

摘　　要：目的探讨冻融胚胎移植(FET)与新鲜胚胎移植的新生儿出生结局。方法收集2009年1月至2013年12月在我中心行体外受精-胚胎移植(IVF-ET)后单胎活产的3 961例患者的临床资料,根据移植胚胎的不同分为鲜胚移植组(2632例)和FET组(1 329例);随机选取同期在我院自然妊娠分娩单胎活产的1 500例产妇作为对照组。比较FET组和鲜胚移植组的助孕资料,以及3组新生儿的分娩孕周、出生体重、早产率、低出生体重比例、极低出生体重比例及巨大儿比例等。结果 FET组患者的平均年龄[(29.76±4.11)岁]显著低于鲜胚移植组[(30.60±4.22)岁](P<0.05)。FET组和鲜胚移植组的新生儿出生体重[分别为(3 329.52±553.95)g和(3 247.89±508.00)g]均显著小于自然分娩组[(3 388.89±461.00)g],但FET组的新生儿出生体重显著高于鲜胚移植组(P均<0.05)。FET组的早产率(8.50%)、低出生体重儿发生率(5.79%)显著低于鲜胚移植组(分别为10.22%、7.33%),而巨大儿出生率(11.44%)显著高于鲜胚移植组(6.50%)和自然分娩组(5.33%)(P均<0.05)。FET组的早产发生率显著高于自然分娩组(3.60%)(P<0.05)。校正年龄因素后,上述差异依然存在。结论 FET助孕后的新生儿结局有优于鲜胚移植周期的趋势,但仍劣于自然妊娠;FET周期巨大儿出生率的增加值得临床关注。Objective： To compare the neonatal outcomes between frozen-thawed embryo transfer and fresh embryo transfer, Methods： The data of 3 961 IVF-ET cycles including 2 632 singletons born after fresh embryo transfer （lET group） and 1 329 singletons born after frozen-thawed embryo transfer （FET group）, and 1500 singletons born of natural conception （NC group） which were randomly selected in our centers in the same period from Jan, 2009 to Dec, 2013 were retrospectively analyzed, The clinical outcomes between FET group and fET group were compared, and the gestational weeks, birth weight, premature birth rate, low birth weight ratio, the proportion of very low birth weight or macrosomia were also compared among the three groups, Results. The age [（29.76±4.11） years] in the FET group was significantly lower than that in the lET group [（30.60±4.22） years] （P〈0.05）. The neonatal birth weight in the lET group and the FET group [（3 329.52±553.95） g, （3 247, 89±508.00） g, respectively] were significantly lower than that in the natural conception group [（3 388.89 ± 461.00） g], and neonatal birth weight in the FET group was significantly higher than that of FET group （all P〈0.05）. The preterm birth rate（8.50% vs. 10.22%） and low birth weight rate（5.79% vs. 7.33%）in the FET group were significantly lower than those than in the lET group （P〈0.05）, while macrosomia rate was significantly higher in FET group （11.44%） than that in lET group （6.50%） and natural conception group （5.33~） （P^0.05）. After adjusting for age, the differences still persisted. Conclusions： Singletons born of FET have a better perinatal outcome compared with singletons born after lET, but a worse perinatal outcome compared with singletons born of natural conception. However, the fetal maerosomia rate was significantly higher in the FET group.

关 键 词：冻融胚胎移植 新鲜胚胎移植 新生儿结局 

分 类 号：R[医药卫生]