激素替代治疗——冻融胚胎移植周期中不同发育天数胚胎的临床结局分析  

The comparison of clinical outcomes of frozen-thawed embryos transfer from different development days

作　　者：王冲 程兆俊 冯颖 周文静 费小阳[1,2] WANG Chong;CHENG Zhao-Jun;FENG Ying(Reproductive Medicine Center,Hangzhou Womens Hospital,Hangzhou Maternity and Child Health Care Hospital,Hangzhou,Zhejiang 310008;Reproductive Medicine Center,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang 310006,China)

机构地区：[1]杭州市妇产科医院生殖医学中心杭州市妇幼保健院生殖医学中心,浙江杭州310008 [2]浙江大学医学院附属杭州市第一人民医院生殖医学中心,浙江杭州310000

出　　处：《中国妇幼保健》2020年第20期3842-3845,共4页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2017KY550);浙江省自然科学基金青年基金项目(LQ18H040009)。

摘　　要：目的探讨冻激素替代治疗—冻融胚胎移植(HRT-FET)周期中第3天(D3)胚胎解冻后当天移植和解冻后过夜培养D4移植对临床结局的影响,为临床上进一步细化FET方案提供参考。方法回顾性分析2016年6月-2019年4月在杭州市妇幼保健院生殖医学中心行全胚冷冻并复苏移植的患者,根据移植时间分为D3组(204例)和D4组(369例),胚胎发育天数和子宫内膜保持同步。结果两组患者女方年龄、不孕年限、体质指数、移植日内膜厚度及移植胚胎数比较,差异均无统计学意义(P> 0.05)。D3组与D4组的临床妊娠率(44.61%vs.45.26%)、着床率(30.92%vs.29.05%)及流产率(13.19%vs.10.78%)比较,差异均无统计学意义(均P>0.05)。按照女方年龄、不孕原因、不孕类型、鲜胚方案、冷冻胚胎评级以及移植次数分层,D3、D4组间临床妊娠率、着床率、流产率比较,差异均无统计学意义(均P>0.05)。结论在HRTFET周期中,可根据实验室安排解冻工作的时间,以及不同发育天数胚胎的发育潜能和特色,综合考虑为患者选择最优的解冻移植方案,改善HRT-FET结局。Objective To investigate the pregnancy outcomes between D3 and D4 embryos from hormone replacement therapy frozen-thawed embryo transfer (HRT-FET). Methods All the patients that enrolled in this study were accomplished HRT-FET in ART center during June,2016 to April,2019. Patients were assigned in two groups according to the different development days,D3 (n = 204),and D4 (n = 369). Embryo development was synchronous with endometrium. Results There were no significant difference between age,Infertility years,BMI, endometrium thickness, number of transferred embryos (P > 0. 05). The clinical pregnancy rate (44. 61%vs. 45. 26%),implantation rate (30. 92% vs. 29. 05%),and abortion rate (13. 19% vs. 10. 78%) in D3 and D4 patients had nosignificant differences (P>0. 05). The clinical pregnancy rate,implantation rate,and abortion rate were no significant difference between D3 and D4 group after stratified by female age,cause of infertility,type of infertility,ovulation induction protocol,frozen embryo criteria rating and transplantation times (P>0. 05). Conclusion In HRT-FET cycle,we need to take schedule of thawing,and potential and characteristics of embryos in different development days into consideration,in order to raise the best thawing transplantation strategy.

关 键 词：不同发育天数 冻融胚胎移植 着床率 临床妊娠率 

分 类 号：R715.2[医药卫生—妇产科学]