冻融胚胎移植时间与子宫内膜转化时间对妊娠结局的影响

目的:探讨冷冻胚胎移植周期(FET)中冻融胚胎移植时间与孕酮作用内膜时间对临床结局的影响。方法:回顾分析2013年8月至2016年1月在广东省妇幼保健院生殖中心行FET周期的1609例不孕患者的妊娠结局,按孕酮作用内膜时间(天)-移植第几天胚胎(天)分为3-3组、3-4组、4-3组和4-4组。结果:各组患者的基本特征之间均无统计学差异。孕酮作用内膜时间与移植胚胎时期同步时,4-4组的种植率(37.3%)明显高于3-3组(25.4%)(P<0.05)。孕酮作用内膜4天时,4-3组的种植率与临床妊娠率(23.4%,34.4%)明显低于4-4组(37.3%,53.1%)(P<0.05)。3-3组和3-4组、3-3组和4-3组及3-4组和4-4组的临床妊娠率、种植率和流产率均无统计学差异(P>0.05)。结论:冻融胚胎移植中,同时延迟孕酮作用时间与胚胎移植时间到第四天有更好的临床结局。移植相同天数胚胎时,孕酮作用内膜3天和4天的临床结局无差异。

The impacts of frozen-thawed embryo and different endometrial transformation time on pregnancy outcomes

Objective:To investigate the pregnancy outcomes of frozen-thawed embryos between different transfer time and different endometrial transformation time in frozen embryo transfer(FET).Methods:We retrospectively analyzed the datas from 1609 infertile patients who underwent FET cycles in Guangdong Women and Children Hospital between August 2013 and January 2016.According to the time of progesterone conversion endometrium and the day of embryo transfer,embryos were divided into groups with 3-3,3-4,4-3 and 4-4.Results:The baseline characteristics of the patients were consistent between the four groups.When the time of progesterone transformation was synchronized with the time of embryo transfer,the rates of implantation was markedly higher in the 4-4 group(37.3%)compared with the 3-3 group(25.4%)(P<0.05).When progesterone transformed the intima for 4 days,remarkably higher rates of implantation and pregnancy were reported 4-4 group(23.4%,34.4%)compared with the 4-3 group(37.3%,53.1%)(P<0.05).There were no statistically significant in rates of pregnancy,implantation,or miscarriage between the groups(3-3 vs 3-4,3-3 vs 4-3,3-4 vs 4-4).Conclusion:Delaying the time of progesterone conversion endometrium and the day of embryo transfer to D4 may have better clinical outcomes in FET.Satisfactory pregnancy outcomes were obtained after 3d,4d transformation of progesterone into endometrium while the same day of embryo was transfered.