冻融胚胎移植的位置对临床结局的影响

Influence of the Location of Frozen-thawed Embryo Transfer on Clinical Outcome

目的:研究腹部超声引导下移植冻融胚胎在子宫腔的位置对临床结局的影响。方法:回顾性分析佛山市妇幼保健院生殖医学中心2006年12月—2008年2月经腹部超声引导下行冻融胚胎移植112例。根据移植胚胎到宫底的距离(DA)分组,分析不同距离与临床结局的关系。同时,根据DA/宫颈内口到宫底的距离(DB)的比值分组,分析不同比值与临床结局的关系。结果:不同DA组间的种植率、妊娠率、早期自然流产率、宫外孕率无统计学意义(P>0.05)。DA/DB的比值不同,临床结局有统计学意义(P<0.05),当1/3≤DA/DB≤1/2时种植率、妊娠率最高。结论:胚胎移植的位置对临床结局有影响,但决定胚胎移植位置时不要用固定参考位置,如胚胎到宫底的距离,而应考虑有功能的宫腔长度。

Objective： To study the influences of the location of frozen-thawed embryo transfer guided by abdominal ultrasound on clinical outcomes. Methods： 112 cases suffered frozen-thawed embryo transfer guided by abdominal ultrasound in our reproductive medical center were analyzed retrospectively from December 2006 to February 2008. All cases were divided into three groups according to the distance from embryo to uterine fundus （DA）, and the relationship between DA and clinical outcomes was analyzed. Meanwhile, all cases were divided into groups according to the ratio of DA and the distance from cervix os to uterine fundus （DB）, and the associations between DA/DB and clinical outcomes were analyzed. Results： No significant differences were observed in implantation rates, pregnancy rates, early spontaneous abortion rates, and ectopic pregnancy rates among different DA groups （P〉0.05）. While the differences between DA/DB and clinical outcomes were significant （P〈0.05）, and the highest implantation rate and pregnancy rate presented when 1/3 ≤ DA/DB ≤ 1/2. Conclusions： Clinical outcomes may be affected by the location of frozen-thawed embryo transfer. However, not the fixed indicator （DA） but the functional length of uterine cavity should be taken into account when we determine the location of embryo transfer.