卵巢过度刺激综合征高风险患者单胚胎移植妊娠结局分析

Analysis of the pregnancy outcomes of single embryo transfer in patients with high risks for ovarian hyperstimulation syndrome

目的:探讨卵巢过度刺激综合征高风险患者单胚胎移植的妊娠结局。方法:回顾性分析2010年3月至2012年3月在我院生殖中心进行体外受精-胚胎移植(IVF-ET)治疗的不孕患者资料,卵巢过度刺激综合征(OHSS)高风险患者行单胚胎移植113个周期(A组),行双胚胎移植173个周期(B组),行全胚冷冻首次冻融胚胎移植122个周期(C组),比较三组之间一般情况、促排情况、胚胎发育情况及临床妊娠率、种植率、多胎率、中重OHSS发生率。结果:三组不孕患者体重指数、基础FSH、Gn使用量、Gn使用时间、HCG注射日E2水平、获卵率、正常受精率、卵裂率、优质胚胎率比较差异均无统计学意义(P>0.05)。C组种植率低于A组和B组(P<0.05),但三组之间的临床妊娠率比较差异均无统计学意义(P>0.05)。中重度OHSS发生率A组(0.88%)和C组(0.82%)明显小于B组(5.78%),多胎率A组(0%)明显<B组(30.38%)和C组(23.81%)差异均有统计学意义(P<0.05)。结论:卵巢过度刺激综合征高风险患者行单胚胎移植可以减小OHSS及多胎妊娠的发生,且不影响临床妊娠率。

Objective To investigate the pregnancy outcomes of single-embryo transfer （SET） in patients with high risks for ovarian hyperstimulation syndrome （OHSS）. Methods Data of patients who received assisted reproductive technology in our center from March 2010 to March 2012 were retrospectively analyzed. Patients with high risks for OHSS were divided into 3 groups： Group A received 113 cycles of SET, Group B received 173 cycles of double embryo transfer （DET）, Group C received 122 cycles of freezing embryo transfer （FET）. The clinical general condition, controlled ovarian hyperstimulation （COH）, embryo development information, pregnancy rate, implantation rate, multiple pregnancy rate, incidence of moderate to severe OHSS were recorded and analyzed. Results The general condition, COH, embryo information among the three groups had no statistical difference （P 〉 0.05）. Implantation rate of FET was lower than those in the other two groups, clinical pregnancy rate among the three groups had no statistical difference （P 〉 0.05）. Multiple pregnancy rate of SET was significantly lower than those in the other two groups, and the occurrence rate of moderate to severe OHSS in group B was higher than those in Group A and C （P 〈 0.05）. Conclusion Single embryo transfer would not reduce pregnancy rate, while could significantly reduce the incidence of OHSS and the multiple pregnancy rates.