不同促排卵方案来源胚胎冻融胚胎移植妊娠结局分析  

Analysis of pregnancy outcome of frozen embryo transfer derived from different ovulation induction regimens.

作　　者：彭琛[1] 吉莉 高倩[1] 孙晓莉[1] PENG Chen;JI Li;GAO Qian;SUN Xiao-li(Reproductive Medicine Center,Affiliated Hospital of Nantong University,Nantong 226001,China;不详)

机构地区：[1]南通大学附属医院生殖医学中心,江苏南通226001 [2]南通大学医学院临床医学系,江苏南通226001

出　　处：《中国实用妇科与产科杂志》2022年第1期96-100,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：江苏省妇幼健康科研项目(F202051)。

摘　　要：目的探讨不同促排卵方案来源胚胎冻融胚胎移植(FET)的妊娠结局。方法回顾性分析2016年1月至2021年5月在南通大学附属医院生殖医学中心接受体外受精或卵泡浆内单精子注射-胚胎移植(IVF/ICSI-ET)治疗,因鲜胚移植失败或全胚冷冻而要求FET的252个周期,根据刺激周期方案的不同将其分为5组:高孕激素促排卵(PPOS)组(n=26)、枸橼酸氯米芬+人绝经期促性腺激素(CC+hMG)组(n=50)、超短方案组(n=57)、拮抗剂组(n=78)及长方案组(n=41),分析各组的临床结局。结果 252个FET周期中,各组体重指数(BMI)、不孕年限、不孕类型、刺激周期时扳机日E2水平/扳机日直径≥14mm卵泡数、移植周期时转化日内膜厚度、转化日E2水平、移植D3胚胎或囊胚比例,差别均无统计学意义(P>0.05)。各组间患者年龄、基础FSH、获卵数、刺激周期Gn总量及平均移植胚胎数,差异有统计学意义(P<0.05)。各组间hCG阳性率、临床妊娠率、流产率及继续妊娠率差异无统计学意义(P>0.05)。但CC+hMG组hCG阳性率、临床妊娠率及继续妊娠率数值上最低,长方案组hCG阳性率、临床妊娠率及继续妊娠率数值上均最高。多因素logistic回归分析发现CC+hMG组FET临床妊娠率低于长方案组,差别有统计学意义(P<0.05),但与其他各组比较差异无统计学意义。其他4组间比较妊娠结局无明显差异(P>0.05)。结论 PPOS、超短方案、长方案、拮抗剂促排卵方案来源胚胎FET妊娠结局在数值上优于CC+hMG促排卵方案,其中长方案显著优于CC+hMG促排卵方案。Objective To compare the pregnancy outcomes of frozen embryo transfer(FET) from different ovulation induction regimens.Methods Retrospectively analyze in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET) treatment at the Reproductive Medicine Center of Nantong University Affiliated Hospital from January 2016 to May 2021.Treatment.The 252 cycles of frozen embryo transfer required due to the failure of fresh embryo transfer or the freezing of whole embryos were divided into five groups according to the different stimulation schemes:PPOS group(n=26),CC+hMG group(n=50),ultra-short regimen group(n=57),antagonist group(n=78) and long regimen group(n=41),and analyze the clinical outcome of each group.Results In the 252 frozen embryo transfer cycles,there was no statistically significant difference in age,BMI,infertility years,infertility type and E2 level on trigger day during stimulation cycle/number of follicles with diameter≥ 14 mm on trigger day,the endometrial thickness,E2 level on transformation day,or the proportion of D3 embryos or blastocysts transferred(P>0.05).There were statistically significant differences in patients’ age,basal FSH,number of eggs harvested,total amount of Gn in stimulation cycle and average number of embryos transferred among all groups(P<0.05).There were no significant differences in hCG positive rate,clinical pregnancy rate,abortion rate or continued pregnancy rate among all groups(P>0.05).However,the hCG positive rate,clinical pregnancy rate and continuing pregnancy rate in CC+hMG group were the lowest,while the hCG positive rate,clinical pregnancy rate and continuing pregnancy rate in long regimen group were the highest.Multivariate Logistic regression analysis showed that the clinical pregnancy rate of FET in CC+hMG group was lower than that in the long regimen group,and the difference was statistically significant(P<0.05),but there was no statistical difference between CC+hMG group and other groups(P>0.05).There was no significant difference in the

关 键 词：体外受精-胚胎移植 排卵诱导/方法 冻融 胚胎 妊娠率 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]