子宫内膜异位症相关不孕患者胚胎移植策略的研究  

Study on embryo transfer strategies in patients with endometriosis-related infertility

作　　者：张玲[1,2,3,4] 黄惠 林津[1,2,3] 高海杰 何雪梅[1,2,3] 施迎迎 李萍 ZHANG Ling;HUANG Hui;LIN Jin;GAO Hai-jie;HE Xue-mei;SHI Ying-ying;LI Ping(Department of Reproductive Medicine,Women and Children's Hospital Affiliated to Xiamen University,Xiamen,Fujian 361003,China;Xiamen Key Laboratory of Reproduction and Genetics,Xiamen,Fujian 361003,China;Xiamen Assisted Reproductive Technology Quality Control Center,Xiamen,Fujian 361003,China;Department of Gynecology,Jimsar County,Xinjiang 831700,China)

机构地区：[1]厦门大学附属妇女儿童医院生殖医学科,福建厦门361003 [2]厦门市生殖与遗传重点实验室,福建厦门361003 [3]厦门市辅助生殖技术质控中心,福建厦门361003 [4]吉木萨尔县中医医院妇科,新疆吉木萨尔831700

出　　处：《中国妇幼保健》2024年第10期1816-1819,共4页Maternal and Child Health Care of China

基　　金：白求恩·医学科学研究基金(QL002DS);福建省厦门市医疗卫生指导性项目(3502Z20209195)。

摘　　要：目的 研究子宫内膜异位症相关不孕患者冻胚移植与鲜胚移植妊娠率的差别,探索子宫内膜异位症相关不孕患者最佳胚胎移植方案。方法 回顾性分析2011年11月-2022年9月厦门大学附属妇女儿童医院生殖医学科1 161例子宫内膜异位症相关不孕患者移植周期的临床资料,根据移植策略分为冻胚移植组(516例)和鲜胚移植组(645例)。比较两组胚胎着床率、临床妊娠率、异位妊娠率、多胎率、流产率、活胎分娩率、早产率、新生儿畸形率等临床妊娠结局。结果 冻胚移植组临床妊娠率为66.7%,鲜胚移植组临床妊娠率为60.0%,两组相比,冻胚移植组临床妊娠率显著增高(χ^(2)=5.46,P<0.05)。冻胚移植组异位妊娠率1.5%、多胎率39.5%、流产率13.7%、活胎分娩率56.6%、早产率19.5%、新生儿畸形率0.8%,与鲜胚移植组异位妊娠率2.8%、多胎率41.1%、流产率10.9%、活胎分娩率51.8%、早产率21.0%、新生儿畸形率0.7%相比,差异均无统计学意义(均P>0.05)。结论 冻胚移植能改善子宫内膜容受性,显著提高子宫内膜异位症相关不孕患者临床妊娠率,改善妊娠结局,且未发现胎儿致畸作用。Objective To research the difference in pregnancy rate between frozen embryo transfer and fresh embryo transfer in patients with endometriosis-related infertility,and explore the optimal embryo transfer scheme for patients with endometriosis-related infertil-ity.Methods The clinical data of 1161 patients with endometriosis-related infertility from Department of Reproductive Medicine,Women and Children's Hospital Affiliated to Xiamen University were analyzed retrospectively,then they were divided into frozen embryo transfer group(516 patients)and fresh embryo transfer group(645 patients).The embryo implantation rates,clinical pregnancy rates,ectopic pregnancy rates,multiple pregnancy rates,miscarriage rates,live birth rates,preterm birth rates,and neonatal malformation rates in the two groups were compared.Results The clinical pregnancy rates in frozen embryo transfer group and fresh embryo transfer group were 66.7%and 60.0%,respectively.The clinical pregnancy rate in frozen embryo transfer group was higher than that in fresh embryo transfer group(X?=5.46,P<0.05).The ectopic pregnancy rate,multiple pregnancy rate,miscarriage rate,live birth rate,preterm bith rate,and neo-natal malformation rate in frozen embryo transfer group were 1.5%,39.5%,13.7%,56.6%,19.5%,and 0.8%,respectively the ectopic pregnancy rate,multiple pregnancy rate,miscarriage rate,live birth rate,preterm birth rate,and neonatal malformation rate in fresh embryo transfer group were 2.8%,41.1%,10.9%,51.8%,21.0%,and 0.7%,respectively,there was no statistically significant difference be tween the two groups(P>0.05).Conclusion Frozen embryo transfer strategy can improve endometrial receptivity,significantly increase clinical pregnancy rate of endometriosis-related infertility patients,and significantly improve pregnancy outcome without fetal teratogenicity.

关 键 词：子宫内膜异位症相关不孕 冻胚移植 鲜胚移植 移植策略 子宫内膜容受性 

分 类 号：R321[医药卫生—人体解剖和组织胚胎学]