不同子宫内膜准备方案对波塞冬标准3组患者冻融胚胎移植妊娠结局的影响  

Effect of different endometrial preparation protocols on pregnancy outcomes of frozen-thawed embryo transfer in Poseidon criteria group 3

作　　者：王佳怡[1] 李欣 凌秀凤[1] 赵纯[1] 季慧[1] WANG Jiayi;LI Xin;LING Xiufeng(Reproductive Center,Nanjing Maternity and Child Health Care Hospital,Women's Hospital of Nanjing Medical University,Nanjing 210004,CHINA)

机构地区：[1]南京市妇幼保健院(南京医科大学附属妇产医院)生殖中心,江苏210004

出　　处：《江苏医药》2023年第12期1197-1202,共6页Jiangsu Medical Journal

基　　金：国家自然科学基金(81971386)。

摘　　要：目的探讨不同子宫内膜准备方案对波塞冬标准3组患者行冻融胚胎移植(FET)妊娠结局的影响。方法回顾性分析行体外受精-胚胎移植助孕治疗且符合波塞冬标准3组的460例患者全胚冷冻后首次FET周期的临床资料,根据子宫内膜准备方案分为A组(采用自然周期方案,88例)、B组(采用人工周期方案,284例)和C组(采用降调节+人工周期方案,88例)。比较三组患者的临床资料和妊娠结局,并分析波塞冬标准3组患者妊娠结局的影响因素。结果三组间患者年龄、抗苗勒管激素水平和子宫内膜厚度比较差异均有统计学意义(P<0.05)。A组和B组临床妊娠率、活产率均高于C组(60.23%和54.58%vs.42.04%、48.86%和45.42%vs.31.82%)(P<0.05);而三组间早期流产率比较差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,在调整其他变量的情况下,与自然周期方案相比,降调节+人工周期方案的临床妊娠率和活产率较低(P<0.05)。结论波塞冬标准3组患者采用自然周期方案准备内膜可获得较为满意的妊娠结局,不增加早期流产率,且简单、经济、安全性高,可作为波塞冬标准3组患者有效的子宫内膜准备方案。Objective To investigate the effect of different endometrial preparation protocols on the pregnancy outcomes of the patients in Poseidon criteria group 3 who underwent frozen-thawed embryo transfer(FET).Methods The clinical data of 460 patients underwent in vitro fertilization-embryo transfer pregnancy-assisted treatment and met the Poseidon criteria group 3 for the first FET cycle after freeze-all strategy were retrospectively analyzed.According to the endometrial preparation protocols,the patients were divided into three groups of A(using natural cycle protocol,88 cases),B(using artificial cycle protocol,284 cases)and C(using down-regulation plus artificial cycle protocol,88 cases).The basic clinical data and pregnancy outcomes were compared among the three groups.The influencing factors for the pregnancy outcomes of the patients in Poseidon criteria group 3 were analyzed by multivariate logistic regression.Results There were statistical differences in the age,level of anti-Mullerian hormone and endometrial thickness among groups of A,B and C(P<0.05).The rates of clinical pregnancy and live birth in groups of A and B were higher than those in group C(60.23%and 54.58%vs.42.04%,and 48.86%and 45.42%vs.31.82%)(P<0.05),whereas there was no statistical difference in the rate of early miscarriage among the three groups(P>0.05).The multivariate logistic regression showed that the rates of clinical pregnancy and live birth of down-regulation plus artificial cycle protocol were lower than those of natural cycle protocol after adjusting for other variables(P<0.05).Conclusion To prepare the endometrium with a natural cycle protocol in the patients in Poseidon criteria group 3 can obtain more satisfactory clinical outcomes,and does not increase the rate of early miscarriage with the advantages of simplicity,economy and high safety,which can be an effective endothelial preparation protocol for the patients in the Poseidon criteria group 3.

关 键 词：冻融胚胎移植 波塞冬标准 妊娠结局 

分 类 号：R711[医药卫生—妇产科学]