基于倾向性评分匹配法探讨胚胎移植液EmbryoGlue对冻胚移植临床结局的影响  

Effect of EmbryoGlue on the clinical outcomes in frozen-thawed embryo transfer based on propensity score matching

作　　者：郝敏 王亮 汪翔 庞文娟 孙宁霞 Min Hao;Liang Wang;Xiang Wang;Wenjuan Pang;Ningxia Sun(Reproductive Medicine Center,the Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China)

机构地区：[1]海军军医大学第二附属医院生殖医学中心,上海200003

出　　处：《中华生殖与避孕杂志》2021年第12期1103-1108,共6页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金青年项目(81901482);上海市医学领先专业重点学科基金(201840315);上海市科技发展基金(19411960700)。

摘　　要：目的研究EmbryoGlue移植液对冻胚移植临床结局的影响。方法回顾性队列研究分析2016年1月1日至2020年12月31日期间于海军军医大学第二附属医院生殖医学中心进行冻胚移植患者的共2848个周期,根据移植培养液种类分为两组:G-2组(1605个周期)和EmbryoGlue组(1243个周期),比较两组患者基本情况及临床结局的差异。将两组患者的年龄、不孕因素、不孕年限、内膜准备方案、内膜厚度、移植胚胎数、移植优质胚胎数、移植胚胎阶段进行倾向性评分匹配(propensity score matching,PSM)后,再次比较两组临床结局的差异。结果PSM前EmbryoGlue组与G-2组比较,患者年龄[(33.46±4.66)岁比(31.92±4.62)岁,P<0.001]、不孕年限[(4.11±2.98)年比(3.36±2.60)年,P<0.001]、内膜厚度[(9.51±1.77)mm比(10.01±1.77)mm,P<0.001]、移植胚胎数(1.52±0.50比1.59±0.49,P=0.001)、移植优质胚胎数(1.28±0.64比1.47±0.57,P<0.001)差异具有统计学意义。PSM后两组基本情况差异均无统计学意义(P均>0.05)。EmbryoGlue组和G-2组的生化妊娠率[61.1%(609/996)比61.9%(617/996),P=0.713]、临床妊娠率[56.5%(563/996)比57.0%(568/996),P=0.821]、植入率[44.3%(674/1523)比44.4%(691/1555),P=0.919]、异位妊娠率[1.8%(10/563)比1.8%(10/568),P=0.984]、流产率[16.9%(95/563)比17.3%(98/568),P=0.865]差异均无统计学意义。结论使用EmbryoGlue作为胚胎移植液的临床结局与G-2相似,尚不能认为EmbryoGlue移植液可以改善冻胚移植的临床结局。Objective To study the effect of embryo transfer medium EmbryoGlue on the clinical outcomes of frozen-thawed embryo transfer.Methods A retrospective cohort study was performed in 2848 cycles from patients undergoing frozen-thawed embryo transfer from January 1,2016 to December 31,2020 in the Reproductive Medicine Center,the Second Affiliated Hospital of Naval Medical University.According to the embryo transfer medium,those cycles were divided into two groups,the G-2 group including 1605 cycles and the EmbryoGlue group including 1243 cycles.Baseline characteristics and clinical outcomes were compared between the two groups.Propensity score matching(PSM)was performed on age,infertility factor,duration of infertility,endometrial preparation protocol,endometrial thickness,number of embryos transferred,number of good-quality embryos transferred and stage of embryo,then clinical outcomes were compared between the two groups again.Results There were significant differences of the age[(33.46±4.66)years vs.(31.92±4.62)years,P<0.001],duration of infertility[(4.11±2.98)years vs.(3.36±2.60)years,P<0.001],endometrial thickness[(9.51±1.77)mm vs.(10.01±1.77)mm,P<0.001],number of embryos transferred(1.52±0.50 vs.1.59±0.49,P=0.001),number of good-quality embryos transferred(1.28±0.64 vs.1.47±0.57,P<0.001)between EmbryoGlue group and G-2 group before PSM.There was no statistically significant difference in the baseline characteristics between the two groups after PSM(all P>0.05).There were no statistically significant differences in biochemical pregnancy rate[61.1%(609/996)vs.61.9%(617/996),P=0.713],clinical pregnancy rate[56.5%(563/996)vs.57.0%(568/996),P=0.821],implantation rate[44.3%(674/1523)vs.44.4%(691/1555),P=0.919],ectopic pregnancy rate[1.8%(10/563)vs.1.8%(10/568),P=0.984]and abortion rate[16.9%(95/563)vs.17.3%(98/568),P=0.865]between the two groups.Conclusion Using EmbryoGlue as embryo transfer medium can obtain the same clinical outcomes as G-2,and EmbryoGlue cannot yet be considered to improve the clinical ou

关 键 词：EmbryoGlue 胚胎移植 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]