两种不同子宫内膜准备方案对FET周期单胎子代围产期结局的影响

目的 探讨冻融胚胎移植(FET)周期中两种不同子宫内膜准备方案对单胎子代围产期结局的影响.方法 回顾性分析2017年1月至2018年12月在空军军医大学唐都医院生殖医学中心通过FET获得单胎活产儿的976个周期.根据不同的子宫内膜准备方案,分为两组:自然周期(NC)组(n=544);激素替代周期(HRT)组(n=432...

Effects of two different endometrial preparation protocols on singleton perinatal outcomes of frozen-thawed embryo transfer cycles

Objective:To explore the two different endometrial preparation protocols on singleton perinatal outcomes of frozen-thawed embryo transfer(FET)cycles.Methods:The data of 976 FET cycle with single live birth was analyzed in our reproductive center between January 2017 to December 2018 were analyzed.According to different endometrial preparation protocols,the cycles were divided into two groups:natural cycles group(NC)(n=544)and hormone replacement therapy cycles group(HRT)(n=432).The patients’general information including female&male age,body mass index(BMI),anti-Müllerian hormone(AMH)level,type,cause&duration of infertility,proportion of patients with polycystic ovary syndrome(PCOS),endometrial thickness and morphology on transfer day,number of embryos transferred,times of transplantation,days of embryos transferred,and assisted hatching(AH)were collected.The incidence of macrosomia,low birth weight rate,premature birth rate,sex ratio at birth,cesarean section rate,average gestational age,average birth weight&length were compared between the two groups.Results:In general data of the two groups,the level of AMH[(4.51±3.62)ng/ml vs.(3.51±2.10)ng/ml],the proportion of patients with PCOS(19.91%vs.5.33%),the number of embryos transferred[(1.65±0.52)vs.(1.57±0.51)],and the rate of cleavage embryos transferred(56.02%vs.53.68%)in HRT group were significantly higher than those in NC group(all P<0.05).In perinatal outcomes,the cesarean section rate(77.78%vs.70.77%),macrosomia rate(8.10%vs.4.96%)and preterm birth rate(7.41%vs.5.88%)in HRT group were also significantly higher than those in NC group(all P<0.05).There was no significant difference in the incidence of low birth weight,sex ratio at birth,average gestational weeks,average birth weight and length between the two groups(P>0.05).After adjusting for confounding factors by multiple regression model,there was no significant difference in preterm birth rate between the two groups(P>0.05),while the macrosomia rate[OR=1.42,95%CI(1.12,2.05)]and cesarean section rate[OR=1.30,95%CI(1.23,1.56)]in HRT group were still significantly higher than those in NC group(P<0.05).Conclusions:Nature cycle protocol of endometrial preparation has lower incidence of macrosomia in single offspring and cesarean section,and has better perinatal outcome following FET compared with HRT protocol.