胚胎移植术中胚胎滞留的发生及其对妊娠结局的影响

目的了解胚胎移植术中胚胎滞留的发生率并探讨其对妊娠结局的影响。方法回顾性分析2017年1月至2020年12月于我院生殖中心行IVF-ET助孕的1834个周期的临床资料,根据胚胎移植术中是否发生胚胎滞留分为两组,发生胚胎滞留的为胚胎滞留组(n=65),未发生胚胎滞留的为对照组(n=1769),比较两组患者的一般资料和妊娠结局;同时,根据移植管不同污染因素分为4个亚组,即血液污染组、粘液污染组、渣污染组和未见异常组,比较各亚组的妊娠结局。结果两组患者一般资料比较无显著差异(P>0.05);两组间临床妊娠率、种植率、异位妊娠率、流产率和活产率比较均无显著差异(P>0.05);胚胎滞留组移植管被血液、粘液污染的发生率(分别为24.62%、16.92%)均显著高于对照组(分别为14.09%、7.70%)(P<0.05),而未见异常的发生率显著低于对照组(50.77%vs.71.48%,P<0.05)。在发生胚胎滞留的情况下,移植管血液污染亚组的临床妊娠率显著低于粘液污染亚组和移植管未见异常组(12.5%vs.63.64%、54.55%,P<0.05);在未发生胚胎滞留的情况下,移植管血液污染亚组的临床妊娠率显著低于粘液污染亚组(44.58%vs.55.88%,P<0.05)。结论本研究提示胚胎移植中胚胎滞留未显著影响妊娠结局,但与移植管粘液污染相比,血液污染可能对妊娠结局带来更多的负面影响。

Embryo retention in embryo transfer and its impact on pregnancy outcome

Objective:To investigate the incidence of embryo retention and its impact on pregnancy outcome.Methods:The clinical data of 1834 IVF-ET cycles in the reproductive center of our hospital from January 2017 to December 2020 were retrospectively analyzed.The patients were divided into two groups according to whether embryo retention occurred during embryo transfer.Those with embryo retention were embryo retention group(n=65)and those without embryo retention were control group(n=1769).The general data and pregnancy outcomes of the two groups were compared.Meanwhile,the patients were divided into four subgroups according to different contaminations,which were blood contamination group,mucus contamination group,residues contamination group and no contamination group.Pregnancy outcomes of different subgroups were compared.Results:There was no significant difference in general data between the two groups(P>0.05).There were no significant differences in the clinical pregnancy rate,implantation rate,ectopic pregnancy rate,abortion rate and live birth rate between the two groups(P>0.05).The blood contamination rate(24.62%vs.14.09%)and mucus contamination rate(16.92%vs.7.70%)in embryo retention group were significantly higher than that in the control group,while the retention rate of no contamination group was significantly lower than that in the control group(50.77%vs.71.48%,P<0.05).In the case of embryo retention,the clinical pregnancy rate of the blood contamination subgroup was significantly lower than that of the mucus contamination subgroup and no contamination group(12.5%vs.63.64%,54.55%,P<0.05).In the absence of embryo retention,the clinical pregnancy rate in the blood contamination subgroup was significantly lower than that in the mucus contamination subgroup(44.58%vs.55.88%,P<0.05).Conclusions:This study suggests that embryo retention does not affect pregnancy outcome,However,blood contamination may have more negative effects on pregnancy outcome than mucus contamination of transplantation tube.