阿托西班在不同年龄胚胎着床失败患者冻融胚胎移植的妊娠结局分析  

Analysis of the Influence of Atosiban on the Pregnancy Outcome of Freeze-thaw Embryo Transfer in Patients with Different Ages

作　　者：李馥洁[1] 裴莉[1] 黄国宁[1] 叶虹[1] LI Fujie;PEI Li;HUANG Guoning(Reproductive and Genetic Institute,Chongqing Health Center for Women and Children,Chongqing Key Laboratory of Human Embryo Engineering,Chongqing Clinical Research Center for Reproductive Medicine,Chongqing 400013,China)

机构地区：[1]重庆市妇幼保健院生殖与遗传研究所重庆市人类胚胎工程重点实验室重庆市生殖医学临床研究中心,重庆400013

出　　处：《实用妇产科杂志》2021年第2期147-151,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨阿托西班对于胚胎着床失败患者进行冻融胚胎移植(FET)的影响。方法:回顾性分析388例着床失败且行FET患者的临床资料,比较<35岁和≥35岁着床失败患者在移植前使用阿托西班治疗组(n=193)和未使用阿托西班对照组(n=195)的胚胎情况及妊娠结局等。结果:对于着床失败1~2次的患者,无论<35岁还是≥35岁的患者中,阿托西班组和对照组的胚胎着床率、生化妊娠率和临床妊娠率比较差异均无统计学意义(P>0.05)。在着床失败≥3次反复着床失败(RIF)的患者,年龄<35岁的患者中阿托西班组的胚胎着床率、生化妊娠率和临床妊娠率分别为33.06%、57.14%和52.38%,均显著高于对照组的22.46%、46.48%和32.39%(P<0.05);年龄≥35岁的患者中,阿托西班组和对照组的胚胎着床率、生化妊娠率和临床妊娠率比较,差异均无统计学意义(P>0.05)。移植前使用单剂量阿托西班治疗后,妊娠期并发症发生率、早产率、低出生体质量儿发生率及出生缺陷发生率与对照组比较,差异均无统计学意义(P>0.05)。结论:移植前使用单剂量阿托西班是安全的,对改善年龄<35岁RIF患者妊娠结局有积极作用。Objective:To observe the effect of Atosiban on frozen-thawed embryo transfer(FET)treatment for patients with the history of embryo implantation failure.Methods:The clinical data of 388 patients who underwent freeze-thaw embryo transfer with the history of implantation failure were analyzed retrospectively.Patients were divided into treatment group(n=193)with atosiban injection,and control group(n=195)without Atosiban injection before transplantation.The embryo status and pregnancy outcome of patients with implantation failure aged<35 years and≥35 years were compared between the two groups.Results:For patients with implantation failure 1 or 2 times,there was no significant difference in embryo implantation rate,biochemical pregnancy rate,and clinical pregnancy rate between the atosiban group and the control group(P>0.05)in patients aged<35 years and≥35 years.In patients with RIF(≥3 times),the embryo implantation rate,biochemical pregnancy rate,and clinical pregnancy rate of the Atosiban group in patients<35 years old were 33.06%,57.14%,and 52.38%respectively,which were significantly higher thanthose in the control group(22.46%,46.48%and 32.39%,respectively)(all P<0.05).Among patients aged≥35 years,there was no significant difference in the embryo implantation rate,biochemical pregnancy rate and clinical pregnancy rate between Atosiban group and the control group(P>0.05).After single-dose Atosiban treatment before transplantation,there was no significant difference in the incidence of complications during pregnancy,premature birth rate,the incidence of low birth weight infants and the incidence of birth defects compared with those in the control group(P>0.05).Conclusions:The use of single-dose Atosiban before transplantationis safe and could significantly improve pregnancy outcomefor RIF patients younger than 35 years.

关 键 词：胚胎着床失败 阿托西班 冻融胚胎移植 临床妊娠 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]