影响冻融胚胎移植结局的年龄节点及相关因素分析  

Analysis of age factors affecting on the outcome of frozen-thawed embryo transfer

作　　者：马荣花[1] 简生燕[1] 祁淑英 王莉云[1] 熊正方[1] 沈源春[1] MA Ronghua;WANG Liyun;QI Shuying;HAN Guohua;JIAN Shengyan;SHEN Yuanchun(Reproductive Medical Center, Qinghai Province People′s Hospital, QingHai 810000, China)

机构地区：[1]青海省人民医院生殖医学中心,西宁810000 [2]龙岗中心医院妇产科,深圳518116

出　　处：《中国生育健康杂志》2020年第5期444-448,共5页Chinese Journal of Reproductive Health

基　　金：青海省科技厅项目(2017-ZJ-740)。

摘　　要：目的寻找影响冻融胚胎移植(FET)妊娠率下降的年龄节点,并探讨影响FET妊娠结局的相关因素。方法回顾性分析2014年2月—2017年12月在青海省人民医院生殖中心行FET的患者,共825周期,年龄21~45岁,绘制年龄-妊娠率趋势图以及ROC曲线,确定FET妊娠率下降的年龄节点。回顾性分析2017年1月—2017年12月就诊于青海省人民医院生殖医学中心行FET的不孕症患者,共282周期,根据年龄分为<36.5岁组与≥36.5岁组,比较两组患者临床妊娠率、早期流产率及活产率,并采用多元回归分析FET患者妊娠结局的影响因素。结果36.5岁后的女性,FET妊娠结局呈明显下降趋势。患者<36.5岁组的妊娠率高于≥36.5岁组,差异有统计学意义(P<0.05)。两组患者早期流产率和活产率,差异无统计学意义(P>0.05)。回归分析提示:<36.5岁组的患者,影响其FET妊娠结局的因素及程度依次为:移植日子宫内膜厚度、优质胚胎率、年龄、卵泡输出率(FORT);而≥36.5岁组的患者,影响其FET妊娠结局的因素及程度依次为:年龄、优质胚胎率、移植日子宫内膜厚度、移植日孕酮水平、移植日雌二醇水平、FORT。结论FET患者在36.5岁后妊娠率呈下降趋势;在此年龄点两侧的妇女FET妊娠结局的影响因素不一样,且同一影响因素的影响程度也不同。Objective To find the age limit of the decline in pregnancy rate of frozen-thawed embryo transfer(FET),and explore relevant factors that affect the pregnancy outcome of FET.MethodsWe analyzed retrospectively the patients of FET in Reproductive Medical Center of Qinghai Province People′s Hospital during February 2014 to December 2017(a total of 825 cycles,aged 21 to 45 years).We also drew the trend chart of age with pregnancy rate,ROC curve,and determined the age limit of the significant decrease in FET pregnancy rate.A retrospective analysis was made on the infertility of FET(a total of 282 treat cycles)in the same hospital from January 2017 to December 2017.We compared clinical pregnancy rate,early miscarriage rate and live birth rate between participants<36.5 years old and those≥36.5 years old.We also used multivariate regression to analyze the influencing factors of pregnancy outcome in FET.ResultsThe pregnancy outcome of FET showed a significant downward trend for women after the age of 36.5.The pregnancy rate of patients<36.5 years old was higher than that of those≥36.5 years old(P<0.05).Miscarriage rate and live birth rate during early pregnancy between the two groups did not differ statistically significant(P>0.05).The results from multivariate regression showed as follows:the degree of factors that affected their FET pregnancy outcome among participants<36.5 years old was:intrauterine membrane thickness in transplantation day,high quality embryo rate,age and follicular output rate(FORT).The degree among participants≥36.5 years old was:age,high quality embryo rate,intrauterine membrane thickness in transplantation day,estrogen level in progesterone day,the level of progesterone in transplantation day and the FORT.ConclusionThe pregnancy rate of FET showed a downward trend after 36.5 years old;and factors which influenced FET pregnancy outcomes were different between two groups,and the degree affecting the same factors was also different.

关 键 词：年龄节点 冻融胚胎移植 妊娠结局 因素分析 

分 类 号：R71[医药卫生—妇产科学]