影响冻融胚胎移植成功的因素分析

目的探讨影响冻融胚胎移植临床妊娠成功的因素.方法对1997年9月至2000年5月行冻融胚胎移植的53例60个周期的资料进行回顾性分析.结果22个胚胎复苏,成活178个胚胎,3个周期因复苏胚胎卵裂球破裂未移植,宫内移植57个周期,平均每个周期移植胚胎3个,周期临床妊娠率30%(17/57).妊娠与非妊娠者的超排卵周期的超排卵方案、卵泡数、获卵数、受精胚胎数、冻存胚胎数及注射绒毛膜促性腺激素前的血雌二醇、促黄体生成素、孕酮水平比较,差异均无显著性(P＞0.05).冻融胚胎移植周期的子宫内膜状态及复苏胚胎的质量与临床妊娠密切相关,17例妊娠者胚胎移植前子宫内膜均呈三线型,胚胎质量良好率(冻存前83.8%、复苏后76.8%,复苏后成活率82.4%)均明显高于非妊娠者(分别为60.7%、50.0%和66.3%),差异均有显著性(P＜0.05).结论胚胎形态良好、子宫内膜呈三线型是冻融胚胎移植后妊娠成功的保证,均质型子宫内膜不宜行胚胎移植.

Analysis of factors influencing the clinical in a frozen thawed embryo transfer program

Objective To analyze the factors influencing the outcome in a frozen thawed embryo transfer (FTET)program Methods Sixty FTET cycles performed in 53 cases from September 1997 to May 2000 were analyzed retrospectively The related parameters were compared between the conceived and non conceived cycles Results One hundred and seventy eight out of 252 thawed embryos were survival Embryo transfers were undergone in 57 cycles (53 patients), resulting in 17 pregnancies (30% per transfer or 28% per thawed cycle) There were no significant difference between conceived and non conceived cycles in terms of the controlled ovarian hyperstimulation protocols, numbers of developed follicle and oocyte retrieved, fertilization rate, numbers of frozen embryo and the luteinizing hormone, estradiol, progesterone levels on human chorionic gonadotropin triggering day The percentage of good quality embryo before freezing and after thawing and survival thawed embryos were higher in conceived cycles than those in non conceived cycles (83 8% Vs 60 7%, 76 8% Vs 50 0%, 82 4% Vs 66 3%, respectively P <0 05) Conclusions Good quality of frozen thawed embryos and the trilaminar sonographic pattern of endometrium may be reliable predictors of success in pregnancy