自然周期移植日孕酮水平对复苏分裂胚及囊胚妊娠结局的影响  

The effect of progesterone level on transplantation day in natural cycle on pregnancyoutcome of resuscitated cleavage embryo and blastocysts

作　　者：宋天然 石缨 张月莲 SONG Tianran;SHI Ying;ZHANG Yuelian(Reproductive Medical Center,Department of Obstetric,Gynecology and Reproductive Science,Air Force Medical Center,PLA,Beijing 100142,China)

机构地区：[1]空军特色医学中心妇产与生殖科生殖医学中心,100142

出　　处：《天津医药》2022年第5期508-512,共5页Tianjin Medical Journal

基　　金：空军特色医学中心科研助推计划课题(2020KTC24)。

摘　　要：目的观察移植日孕酮(P)水平对自然周期冷冻复苏胚胎(FET)妊娠结局的影响。方法回顾性分析以自然周期进行内膜准备的549个FET周期,其中分裂胚组211个周期,囊胚组338个周期。按移植日P水平不同,将2组各分为4个亚组。分裂胚组为:≤10μg/L组15例、>10~20μg/L组84例,>20~30μg/L组70例和>30μg/L组42例;囊胚组为:≤15μg/L组35例,>15~25μg/L组135例,>25~35μg/L组83例和>35μg/L组85例。对各组间年龄、内膜厚度、平均移植胚胎数、排卵前卵泡直径、移植日激素水平、移植胚胎数、临床妊娠率、着床率、流产率、异位妊娠率、分娩率、分娩活婴男女比例进行比较。结果分裂胚组平均移植胚胎数、异位妊娠率明显高于囊胚组,囊胚组移植日雌激素(E2)、P水平、妊娠率、着床率、分娩率高于分裂胚组(P<0.01),2组间年龄、内膜厚度、排卵前卵泡直径、流产率、分娩活婴男女比例差异无统计学意义。分裂胚组和囊胚组中各亚组间年龄、内膜厚度、平均移植胚胎数、卵泡直径、移植日E2水平、妊娠率、着床率、流产率、异位妊娠率和分娩率的差异均无统计学意义。结论自然周期FET时囊胚着床率明显高于分裂胚;移植日P水平在囊胚或分裂胚对妊娠结局无明显影响,但选择移植分裂胚时应更慎重。Objective To observe the effect of progesterone(P)level on the pregnancy outcome of natural cycle frozen thawed embryo(FET).Methods A retrospective analysis was performed on 549 FET cycles with natural cycles,including 211 cycles in the cleavage embryo group and 338 cycles in the blastocyst group.The two groups were divided into 4 subgroups according to P level on transplantation day.The divided embryo groups were:the≤10μg/L group(n=15),the>10-20μg/L group(n=84),the>20-30μg/L group(n=70)and the>30μg/L group(n=42).The divided blastocyst groups were:the≤15μg/L group(n=35),the>15-25μg/L group(n=135),the>25-35μg/L group(n=83)and the>35μg/L group(n=85).Data of age,endometrial thickness,average number of transplanted embryos,diameter of follicle before ovulation,hormone level on the day of transplantation,number of transplanted embryos,clinical pregnancy rate,implantation rate,abortion rate,ectopic pregnancy rate,delivery rate and male/female ratio were compared between the blastocyst group,the split embryo group and the subgroups.Results The average number of embryo transfer,ectopic pregnancy rate were significantly higher in the splitting embryo group than those of the blastocyst groups.Data of E2,P level,childbirth,implantation rate and pregnancy rate were higher in the blastocyst transplant group than those of the splitting embryo group(P<0.01).There were no significant differences in age,lining thickness,diameter of follicle before ovulation,abortion rate and ratio of male to female births between the two groups.There were no significant differences in age,endometrial thickness,average number of transplanted embryos,follicular diameter and E2 level,implantation rate,pregnancy rate,abortion rate,ectopic pregnancy rate and delivery rate between the subgroups of split embryo group and the blastocyst group.Conclusion The implantation rate of blastocyst is significantly higher than that of split embryo in natural periodic FET.Although P level on transplantation day shows no significant effect on pregnancy o

关 键 词：孕酮 胚胎移植 囊胚 妊娠结局 冷冻 妊娠率 子宫内膜 分裂胚 自然周期 

分 类 号：R711.6[医药卫生—妇产科学]