高龄女性累积胚胎后移植与非累积胚胎移植的妊娠结局分析

目的 比较40岁以上高龄女性累积胚胎后移植与非累积胚胎进行移植的妊娠结局。方法选择40岁以上且使用自身卵子进行冻融胚胎移植助孕229例不孕症妇女共338个周期资料，根据患者是否累积胚胎移植分为两组分析妊娠结局。 结果40~49岁女性随着年龄增高，基础卵泡刺激素水平升高（P<0.05），获卵数减少（P<0.05），临床妊娠率和持续妊娠率下降（P<0.05）。在40岁妇女中，累积胚胎移植组的临床妊娠率和持续妊娠率均高于非累积胚胎移植组（42.9% vs. 24.6%，P<0.05），对于41岁、42岁、≥43岁，两组的临床妊娠率、持续妊娠率及早期流产率差异均无统计学意义（P＞0.05）。结论对于40岁不孕妇女，多次取卵累积胚胎后移植有助于提高临床妊娠率，对41岁以上女性累积胚胎对于助孕结局的益处有限。

Pregnancy outcomes of cumulative and non-cumulative embryo transfer in women over 40 years old

Objective To investigate the pregnancy outcomes of cumulative and non-cumulative embryo transferred in women over 40 years old. Methods A total of 338 cycles of 229 infertile women over 40 years old, who used their own oocytes, were selected and divided into two groups according to whether the patients accumulated embryo transfer or not. Results With the increase of age, the basal FSH level significantly increased while the number of oocytes retrieved significantly decreased (P<0.05); and the clinical pregnancy rate and persistent pregnancy rate significantly decreased (P<0.05). Among 40 years old women, the clinical pregnancy rate and persistent pregnancy rate of cumulative embryo transfer group were significantly higher than those of non-cumulative embryo transfer group (42.9% vs. 24.6%, P<0.05). There was no significant difference in clinical pregnancy rate, persistent pregnancy rate or early abortion rate between the two groups of 41 years old, 42 years old and over 43 years old (P>0.05). Conclusion For infertile women aged 40 years, multiple oocytes retrieval for cumulative embryo transfer can improve the clinical pregnancy rate. For women over 41 years old, the benefit of embryo accumulation on pregnancy outcome is limited.