玻璃化冻融人卵裂期胚胎移植结局的影响因素分析

目的:探讨玻璃化冻融人第3天卵裂期胚胎移植结局的影响因素。方法:回顾分析977例1301个冻融胚胎移植周期,根据患者年龄、新鲜周期结局、移植胚胎质量等因素分组,比较各分组的胚胎植入率、临床妊娠率。结果:复苏3598个胚胎,存活3462个。周期临床妊娠率24.1%,出生婴儿291个。新鲜周期结局、移植胚胎质量组间胚胎着床率、临床妊娠率的差异有统计学意义(P<0.01)。子宫内膜准备方案、胚胎的复苏程度组间差异无统计学意义(P>0.05)。不同年龄组相同不孕年限亚组间的胚胎着床率、临床妊娠率的差异有统计学意义(P<0.05)。移植日子宫内膜厚度>12.0mm组与其他两组相比,胚胎着床率、临床妊娠率较高(P<0.05);不同FET次数组间,1次组的胚胎着床率、临床妊娠率明显高于其他两组(P<0.01)。非条件逐步logistic回归分析表明年龄(P<0.01,OR=0.43)、FET次数(2次组P<0.01,OR=0.30;3次组P<0.01,OR=0.19)、新鲜周期结局(P<0.01,OR=9.01)、移植胚胎质量(P<0.01,OR=3.52)与移植结局相关。结论:年龄、新鲜周期结局、移植胚胎质量等是影响冻融胚胎移植结局的重要因素。

Analysis of influencing factors on the outcomes of the vitrified-warmed human day 3 embryo transfer

Objective:To explore the factors affecting the FET outcomes of human day 3 cleavage-stage embryos vitrified.Methods:1301 FET cycles of 977 patients were analyzed in human reproductive medicine center of Hainan medical college,and they were grouped according to the age of patients,the outcome of fresh cycles and the quality of embryos transferred,etc.The implantation rate and clinical pregnancy rate were compared between various groups.Result:A total of 3598 embryos were thawed,of which 3462 embryos survived.The clinical pregnancy rate per cycle was 21.4%(314/1301)and 291 babies were born.Among the groups of the outcome of fresh cycles,quality of embryos transferred,the implantation rate and clinical pregnancy rate were significant difference(P<0.01).However,the groups of endometrial preparation program and survival cell ratio of embryo recovery had no significant effect on implantation rate and clinical pregnancy rate(P>0.05).The same groups of infertility duration in different age groups had a significant effect on implantation rate and clinical pregnancy rate(P<0.05).The implantation rate and clinical pregnancy rate in>12.0mm group of endometrial thickness were higher compared with the other two groups(P<0.05).Among the different groups of FET cycles,the implantation rate and clinical pregnancy rate(P<0.01)in the 1 time group were highest.Non-conditional stepwise regression analysis was showed the age(P<0.01,OR=0.43),the number of FET cycles(2 cycles group P<0.01,OR=0.30;3 cycles groupP<0.01,OR=0.19),the outcome of fresh cycles(P<0.01,OR=9.01),quality of embryos transferred(P<0.01,OR=3.52)were related to outcomes of the vitrified-warmed human day 3 embryo transfer.Conclusion:In the FET cycles,the pregnancy rate and implantation rate are associated with age,the outcome of fresh cycles,quality of embryos transferred,etc.