40岁以上女性玻璃化冻融胚胎移植替代新鲜胚胎移植可行性分析

目的 探讨40岁以上女性采用全胚胎玻璃化冻融胚胎移植替代新鲜胚胎移植作为超促排卵体外受精-胚胎移植周期首次移植的可行性。方法 回顾性分析中南大学湘雅医院生殖中心 2011年4月至2012年2月1863例新鲜胚胎移植周期和1083例玻璃化冻融胚胎移植周期的临床资料，应用多因素Logistic回归方法，分析临床相关因素与临床妊娠率的关系。 结果 女性年龄超过40岁时，玻璃化冻融胚胎移植的临床妊娠率显著高于新鲜胚胎移植的临床妊娠率（32.56% vs. 16.10%, P<0.05）；多因素Logistic回归分析显示移植周期类型与临床妊娠密切相关，玻璃化冻融胚胎移植对新鲜胚胎移植的妊娠优势比为2.49（95%CI 1.09～5.69,P<0.05）。 结论 年龄超过40岁女性采用玻璃化冻融胚胎移植可获得比新鲜胚胎移植更好的妊娠结局。

Feasibility analysis of vitrified frozen-thawed embryo transfer instead of fresh embryo transfer in women over 40 years of age.

Abstract： Objective To investigate whether the whole embryo vitrified frozen-thawed embryo transfer(vFET) instead of fresh embryo transfer (fET) in a controlled ovarian hyperstimulation(COH) cycle improves the in vitro fertilization-embryo transfer(IVF-ET ) clinical outcomes in elderly women. Methods The investigators retrospectively analyzed the clinical data of 1863 cases of fET cycles and 1083 cases of vFET cycles, which were performed during the period of 2011 April to 2012 February in the Reproductive Medical Center of Xiangya Hospital. Multivariate logistic regression was used to analyze the relationship between the related clinical factors and pregnancy rate. Results The clinical pregnancy rate of elderly women (more than 40 years old) was significantly higher in the group of vFET cycles than that in fET cycles（32.56% vs. 16.10%, P<0.05).Multivariate logistic regression analysis revealed that the type of embryo transfer cycle and clinical pregnancy rate were closely related, with a greater pregnancy probability in vFET cycles than in fET cycles (odds ratio: 2.49,95% confidence interval: 1.09-5.69, P<0.05). Conclusion Vitrified frozen-thawed embryo transfer results in a better pregnancy outcome than fresh embryo transfer in women who are more than 40 years old.