高龄妇女冻融周期胚胎移植策略的选择  

Suitable embryo transfer strategy for females with advanced age in frozen embryo cycle

作　　者：刘杰[1] 郑洁[1] 雷亚兰[1] 文晓凤[1] 夏敏[1] 孙虹[1] LIU Jie;ZHENG Jie;LEI Yalan;WEN Xiaofeng;XIA Min;SUN Hong(Reproductive Medicine Center of Hubei Women and Children′s Hospital,Wuhan 430070,China)

机构地区：[1]湖北省妇幼保健院生殖医学中心,武汉430070

出　　处：《实用医学杂志》2018年第15期2467-2470,共4页The Journal of Practical Medicine

摘　　要：目的了解本中心冻融胚胎移植(FET)影响临床结局的年龄界限值,并探讨高龄妇女冻融周期胚胎移植策略。方法回顾性分析2014-2016年在本中心行FET的患者临床妊娠率及流产率,找出高龄患者的年龄分界点,并根据内膜准备方案将高龄患者分为自然周期(NC)组、促排卵周期(COH)组和激素替代周期(HRT)组,根据移植胚胎类型分为胚胎移植组和囊胚移植组,分别比较各组的临床妊娠率、胚胎着床率、流产率及活产率。结果 38岁后患者的临床妊娠率和活产率急剧下降。高龄患者在冻融周期内膜准备时,NC组、COH组和HRT组患者的临床妊娠率和活产率差异均无显著性(P>0.05)。但囊胚移植患者的临床妊娠率和活产率均明显高于胚胎移植组,差异具有统计学意义(P<0.01)。结论38岁是本中心高龄妇女的年龄分界点,高龄患者内膜准备方案并不影响TET临床结局,行囊胚移植可以获得更好的临床结局。Objective To find out the cut′off age for females with advanced age undergoing IVF-ET and to explore the embryo transfer strategy for them in the frozen thawed cycle.Methods The data of the patients in frozen thawed embryo transfer cycle from 2014 to 2016 were retrospectively analyzed to find the cut′off point of age for women with advanced age undergoing IVF-ET.According to the endometrial preparation program,the patients were divided into natural cycle(NC)group,ovulation period(COH)group and hormone replacement cycle(HRT)group.According to the type of transfer embryos,the patients were also divided into embryo transplantation group and blastocyst transplantation group,and then the clinical pregnancy rate,abortion rate and live birth rate were com pared among the groups.Results After 38 years of the age,the clinical pregnancy rate decreased dramatically and the rate of abortion increased significantly.During the frozen embryo thawing cycle,the clinical pregnancy rate of the NC group,COH group and HRT group and the live birth rate were no significantly different(P>0.05).But the clini cal pregnancy rate and the live birth rate of the blastocyst transplant patients were significantly higher than those of the embryo transfer(P<0.01).Conclusions The age of 38 is a cut-off for the women with advanced age undergoing IVF-ET in our center.Selection of different endometrial preparations during the freezing thawing cycle exerts no influ ence on the clinical outcome of the patients and blastocyst transplantation indicates better clinical outcomes.

关 键 词：高龄妇女 冻融胚胎移植 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]