体外助孕-冻胚移植中激素替代周期与孕后子痫前期的相关性分析

目的:探讨辅助生殖助孕中冻胚移植内膜准备方案与妊娠后子痫前期发生的关系。方法:回顾分析2011年1月至2018年1月在山东大学附属生殖医院行冻胚移植后获得单胎活产的8872例不孕患者的临床资料,根据内膜准备方案分为促排卵周期2332例与激素替代周期6540例。主要结局指标是子痫前期,诊断的确立均依据临床指南;同时记录所有患者的临床资料,包括基线数据及胚胎实验室相关信息。结果:激素替代周期组的子痫前期发生率明显高于促排卵周期组(8.8%vs 4.9%,P<0.001)。多因素logistic回归分析显示,在校正混杂因素后,激素替代周期仍是子痫前期发生的独立危险因素(OR=1.70,95%CI为1.29~2.24,P<0.001)。结论:相比促排卵周期,应用激素替代周期作为冻胚移植前内膜准备方案与妊娠后并发子痫前期相关。

Association between the risk of pre-eclampsia and the programming regimen for endometrium preparation for frozen-thawed embryo transfer

Objective:To investigate the association between the risk of pre-eclampsia and different protocols for endometrial preparation when performing frozen-thawed embryo transfer(FET).Methods:A total of 8872 women who had a singleton livebirth achieved by FET were included in this retrospective study.The datas were collected at the center for Reproductive Medicine Affiliated to Shandong University from January 2011 to January 2018.Women were classified into two groups according to the protocols for endometrium preparation:either stimulated cycle(n=2332)or programming cycle(n=6540).Primary outcome was the risk of pre-eclampsia diagnosed by recommended guidelines.Clinical-related parameters such as baseline characteristics and embryonic development were also compared between the two groups.Results:The risk of pre-eclampsia was significantly higher in the programming cycle for FET(8.8%vs 4.9%in the stimulated cycle,P<0.001).Logistic regression analysis showed that,as compared to the stimulated cycle,programmed cycle was associated with a higher risk of pre-eclampsia in pregnancy(adjusted odds ratio 1.70,95%confidence interval 1.29~2.24,P<0.001).Conclusion:The increased risk of pre-eclampsia was associated with the programming cycle when performing FET,possibly being attributable to an absence of corpus luteum.