冻融胚胎移植在薄型子宫内膜患者的临床结局

目的探讨冻融周期胚胎移植在子宫内膜厚度8mm的患者中的应用价值。方法回顾性分析2011年1月至2013年6月在本中心接受IVF/ICSI-ET治疗、子宫内膜厚度8mm的患者,共194个周期的临床资料。按移植胚胎类型分为2组:A组:新鲜胚胎移植组(n=120),B组:冻融胚胎移植组(n=74)。随机选取同期子宫内膜厚度≥8mm患者,共388个周期,按移植胚胎类型分为2组:C组:新鲜胚胎移植组(n=182),D组:冻融胚胎移植组(n=206)。分别比较组间的临床妊娠率、胚胎种植率和早期流产率。结果 A组和B组的临床妊娠率(24.2%vs.43.2%)和胚胎种植率(16.1%vs.23.7%)均有显著性差异,A组均显著低于B组(P0.05),但两组间早期流产率差异无统计学意义(17.2%vs.18.8%,P0.05)。C组和D组的临床妊娠率(49.5%vs.46.6%)和胚胎种植率(28.6%vs.28.2%)差异均无统计学意义(P0.05),且两组间早期流产率差异亦无统计学意义(11.1%vs.9.4%,P0.05)结论对子宫内膜厚度8mm患者,选择冻融周期胚胎移植可获得更高的临床妊娠率和种植率,但不能降低早期流产率。

Application value of frozen-thawed embryo transfer in patients with thin endometrium

Objective： To explore the value of frozen-thawed embryo transfer in women with endometrial thickness less than 8 ram. Methods： The data of 194 IVF/ICSI-ET cycles performed in the 105th Hospital of PLA from January 2011 to June 2013 were analyzed retrospectively. The endometrial thickness of these patients was less than 8 mm. According to different protocols of embryo transplantation,all the patients were divided into group A （fresh embryo transfer, n = 120） and group B （frozen-thawed embryo transfer, n = 74 i. Furthermore, 388 patients with endometrial thickness-8 mm were randomly＇ selected and divided into group C（fresh embryo transfer,n-----182） and group D（ frozen-thawed embryo transfer, n = 206）. The clinical ＇outcomes were compared among the groups respectively. Results： The clinical pregnancy rate（24.2% vs. 43.2%）iand implantation rate（16.1% vs. 23.7%）in group A were significantly higher than those in group B（P〈0.05）. The early miscarriage rate had no significant difference between the two groups （17.2% vs18.8%, P〈0.05）. Meanwhile, the clinical pregnancy rate （49.5 % vs. 46.6%）, implantation rate （28.6 % vs. 28.2%） and the early miscarriage （11.1% vs. 9.4%）had no significant differences between group C and D. Conclusions： Frozen-thawed embryo transfer improves the clinical pregnancy rate and implantation rate in women with thin endometrium,but fails to decrease the early miscarriage rate.