长方案全胚胎冷冻保存后首次冻融胚胎移植时机研究

目的探讨体外受精-胚胎移植(IVF-ET)患者采用长方案行超排卵后全胚冷冻,首次冻融胚胎移植时机。方法选择青海省人民医院生殖中心171例IVF-ET患者,均采用促性腺激素释放激素激动剂长方案行控制性超排卵,取卵后行全胚冷冻,根据胚胎冷冻日到冻融胚胎移植日的间隔时间分为两组,分别为间隔短(≤69 d)组80例,间隔长(>69 d)组91例,比较两组患者获卵率、受精率、卵裂率、获胚胎数、优胚率、ET优胚胎率、临床妊娠率。结果两组患者年龄、基础内分泌、不孕原因、不孕年限、BMI、子宫内膜准备方案、胚胎种类及获卵数均无明显差异。间隔短(≤69 d)组患者HCG日雌二醇(E2)水平低于间隔长(>69 d)组患者,差异有统计学意义。间隔短(≤69 d)组患者卵裂率、优胚数、临床妊娠率均高于间隔长(>69 d)组,差异有统计学意义。结论促性腺激素释放激素激动剂长方案患者,首次行经后即可复诊行冻融胚胎移植准备。

Timing for frozen-thawed embryo transfer in long-term regimen

Objective To investigate the timing for freeze-all embryos transfer from patients undergoing superovulation and in vitro fertilization-embryo transfer(IVF-ET)in long-term regimen.Methods 171 patients for IVF-ET were selected in reproductive center of Qinghai Renmin Hospital and subjected to controlled ovarian hyperstimulation using gonadotropin-releasing hormone agonist in long-term regimen.Eggs were harvested and fertilized in vitro,and all embryos were cryopreserved.Based on the interval between the cryopreservation and the transfer of frozen-thawed embryos,80 patients with an interval≤69 days were divided into short interval group and 91 cases with an interval>69 days were divided into long interval group.We compared the egg retrieval rate,fertilization rate,cleavage rate,number of harvested embryos,high-quality embryo rate,high-quality embryo rate for ET and clinical pregnancy rate between the two groups.Results There were no significant differences in age,basal hormone level,infertility factors,infertility age,BMI,solution for endometrium preparation,embryo types and the number of harvested eggs between the two groups.The estradiol(E 2)level of patients on the HCG day in short interval group was lower than that in long interval group(P<0.05).The cleavage rate,number of high-quality embryo,high-quality embryo rate for ET and clinical pregnancy rate of patients in short interval group were higher than those in long interval group(P<0.05).Conclusion The patients with gonadotropin-releasing hormone agonists in long-term regimen can be re-diagnosed for frozen-thawed embryo transfer after the first menstruation.