38岁以上体外受精-胚胎移植患者采用长方案新鲜胚胎移植与黄体期促排卵方案首次解冻移植临床结局的比较

Comparison of clinical outcomes of long-term fresh embryo transfer and luteal phase ovulation induction thawing transplantation for in vitro fertilization-embryo transfer patients over 38 years old

目的 探讨38岁以上体外受精-胚胎移植患者采用长方案新鲜胚胎移植与黄体期促排卵方案首次解冻移植临床结局的比较.方法 本研究共纳入大于38岁采用GnRH-a长方案新鲜移植55个周期,黄体期促排卵后首次解冻移植47个周期.比较两组的获卵数、可移植胚胎数、优质胚胎数、临床妊娠率及早期流产率.结果 两组在获卵数、可移植胚胎数、优质胚胎数、临床妊娠率及早期流产率差异无统计学意义(P>0.05).结论 对于38岁以上体外受精-胚胎移植患者采用黄体期促排卵方案首次解冻移植不能提高临床妊娠率,但相较于GnRH-a长方案组,黄体期组Gn天数和Gn用量均较少,在成本效益上,黄体期方案更优.

Objective To compare the clinical outcomes of long-term fresh embryo transfer and luteal phase ovulation induction thawing transplantation for in vitro fertilization-embryo transfer(IVF-ET)patients over 38 years old.Methods In this study,55 cycles of fresh transplantation with GnRH-a long regimen and 47 cycles of thawing transplantation after luteal ovulation induction were included in the study.The number of ovum obtained,transferable embryos,high quality embryos,clinical pregnancy rate and early abortion rate were compared between the two groups.Results There was no significant difference between the two groups in the number of harvested eggs,the number of transplantable embryos,the number of high-quality embryos,clinical pregnancy rate and early abortion rate(P>0.05).Conclusion For in vitro fertilization-embryo transfer(IVF-ET)patients over 38 years old,the first thawing and transplantation in luteal phase cannot improve the clinical pregnancy rate,but compared with GnRH-a long-term regimen group,the number of days of Gn and the amount of Gn used in luteal phase group are less,and the luteal phase regimen is better in cost-effectiveness analysis than GnRH-a long-term regimen group.