年龄≤35岁卵巢储备功能低下女性的冻融胚胎移植周期获得活产的围产期结局分析  

Analysis of perinatal outcomes of≤35 years old women with diminished ovarian reserve obtained live births in frozen-thawed embryo transfer cycles

作　　者：韦梦洁 魏艳 冯光恩 陈秋菊[1] 柴蔚然[1] Wei Mengjie;Wei Yan;Feng Guangen;Chen Qiuju;Chai Weiran(Reproductive Medicine Department of Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院辅助生殖科,上海200011

出　　处：《中华生殖与避孕杂志》2022年第8期791-801,共11页Chinese Journal of Reproduction and Contraception

基　　金：上海市科学技术委员会科研计划项目(19411961100);上海交通大学医学院附属第九人民医院临床研究助推计划资助(JYLJ202002)。

摘　　要：目的探讨卵巢储备功能低下(diminished ovarian reserve,DOR)对年龄≤35岁患者通过冻融胚胎移植(frozen-thawed embryo transfer,FET)周期获得活产的围产期结局影响。方法回顾性队列研究分析2006年1月至2018年12月期间在上海交通大学医学院附属第九人民医院辅助生殖科就诊的≤35岁不孕妇女在FET治疗后妊娠≥24周的围产期结局资料。将患者分为非DOR组(n=14342)和DOR组(n=1292)。主要观察指标为新生儿低出生体质量发生率,次要观察指标包括婴儿胎龄、出生体质量、性别以及先天性缺陷、新生儿死亡和产妇妊娠期合并症的发生率。采用单因素及多因素二元logistic回归,统计分析DOR与活产新生儿出生结局以及产妇妊娠期合并症发生率的相关性。结果DOR组分娩单胎、双胎的新生儿出生体质量与非DOR组相比差异均无统计学意义(均P>0.05)。两组间新生儿低出生体质量、早产、先天性缺陷、新生儿死亡以及产妇妊娠期合并症的发生率等差异均无统计学意义(均P>0.05)。经多因素logistic分析校正混杂因素后,DOR不是年龄≤35岁患者行FET获得单胎以及双胎活产时发生低出生体质量的危险因素(单胎校正OR=0.97,95%CI=0.69~1.34,P=0.831;双胎校正OR=1.14,95%CI=0.95~1.36,P=0.166)。结论对于年龄≤35岁的DOR患者行FET获得的活产儿出生结局与非DOR患者相当。Objective To investigate the effect of diminished ovarian reserve(DOR)on perinatal outcomes of young patients obtained live births through frozen-thawed embryo transfer(FET)cycles.Methods In this retrospective cohort study,data of perinatal outcomes of patients who underwent FET and achieved pregnancy≥24 weeks from January 2006 to December 2018 in Reproductive Medicine Department of Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine were analyzed.Patients were divided into non-DOR group(n=14342)and DOR group(n=1292).The main outcome measure was the rate of low birth weight of newborns.The secondary outcome measures included infant gestational age,birth weight,gender,and incidence of congenital defects,neonatal death,and pregnancy complications.Univariate and multivariate logistic regression were applied to analyze the correlation between DOR and the outcomes of newborns and the rates of pregnancy complications.Results There was no statistically significant difference in the birth weight of newborns between DOR group and non-DOR group in both singleton and twin pregnancies(all P>0.05).There were no significant differences in incidence of low birth weight,preterm birth,congenital defects,neonatal death,and pregnancy complications between the two groups(all P>0.05).After adjusting for relevant confounders by multivariate logistic regression analysis,DOR was not a risk factor for patients≤35 years old to obtain singletons and twins with low birth weight through FET(singletons adjusted OR=0.97,95%CI=0.69-1.34,P=0.831;twins adjusted OR=1.14,95%CI=0.95-1.36,P=0.166).Conclusion The birth outcomes of live births obtained by FET in DOR patients≤35 years old were comparable to those obtained in non-DOR patients.

关 键 词：受精 体外 卵巢储备 冻融胚胎移植 子代 

分 类 号：R714.8[医药卫生—妇产科学]