高龄患者冻融胚胎移植中不同黄体支持方案对妊娠结局的影响

目的探讨不同黄体支持方案对高龄助孕患者行激素替代周期冻融胚胎移植(hormone replacement therapy-frozen-thawed embryo transfer,HRT-FET)时妊娠结局的影响。方法收集2011.01-2015.12期间行HRT-FET移植且年龄≥35岁患者的临床资料进行回顾性分析。依据内膜转化日不同黄体支持方案,分为黄体酮针组(A组,n=588),雪诺同组(B组,n=224),所有患者均口服地屈孕酮片(20 mg/d)。比较组间临床妊娠率、着床率、流产率、宫外妊娠率及活产率之间的差异。结果临床及实验室一般资料组间无统计学差异(P0.05),A组临床妊娠率(36.6%)及着床率(20.3%)较B组(27.2%和15.1%)高,差异有统计学意义(P0.05)。单因素及多因素Logistic回归分析显示,早期流产率组间差异有统计学意义(P0.05)。结论在高龄患者HRT-FET中,2种黄体支持方案妊娠结局相似,患者可根据个人经济情况选择。

Effect of different luteal support schemes on pregnancy outcome during frozen-thawed embryo transfer in elderly patients

Objective To compare the difference of pregnancy outcome between the intramuscular progesterone (IMP) and vaginal gel (Crinone 8％) in advanced maternal age with hormone replacement therapy-frozen-thawed embryo transfer (HRT-FET).Methods A retrospective cohort study was performed in the patients aged 35 years or older with HRT-FET during January 2011 to December 2015.Based on the different luteal support schemes on the endometrium transformation day,they were divided into two groups,group A with IMP (n=588) and group B with Crinone 8％ (n=224),and all the patients in the two groups were given 20 mg dydrogesterone tablets daily.The basic characterstics were compared and the difference of the thawing recovery success rate,clinical pregnancy rate,embryo implantation rate,abortion rate,ectopic pregnancy rate and live birth rate were analyzed between the two groups.Results Clinical and laboratory data between the two groups had no significant difference (P＞0.05).Group A had higher clinical pregnancy rate (36.6％) and embryo implantation rate (20.3％) than group B (27.2％ and 15.1％) (P＜0.05).Single factor and multiple factors Logistic regression analysis showed that early abortion rate had significant difference between the two groups (P＜0.05).Conclusion In elderly patients with HRT-FET,the two groups had the similiar pregnancy outcome.People could select any one based on their personal.