不同年龄两种内膜准备方案对冻胚移植结局的影响

Frozen embryo transfer outcome of two endometrial preparation protocols in patients of different ages

目的回顾性分析727例不同年龄组两种内膜准备方案的冻胚移植（FET）结局，探索不同年龄患者更适合的内膜准备方案。方法按不同年龄分为：Ⅰ组：〈25岁；Ⅱ组：25—29岁；Ⅲ组：30-34岁；Ⅳ组：35—39岁；Ⅴ组：≥40岁。按照内膜准备方案分为：自然周期组（A组）和激素替代周期组（B组），比较自然周期和激素替代周期各年龄组之间妊娠结局的差异。结果A、B两组患者的临床妊娠率比较差异有统计学意义（P〈Q05）；自然周期的临床妊娠率随年龄的增长逐渐下降，但两组患者不同年龄组的胚胎种植率、临床妊娠率和流产率比较差异均无统计学意义（P〉0．05）。结论对年龄偏大的患者行冻融胚胎移植时更倾向于应用激素替代周期来准备内膜。

Objective To retrospectively analyze the outcomes of 727 patients of different ages with two kinds of endometrial preparation protocols for frozen embryo transfer, and to investigate more suitable endometrial preparation protocols. Methods Firstly, the patients were divided into 5 groups according to the different age. 〈 25 years old; 25 -29 years old; 30 -34 years old; 35 -39 years old; ≥ 40 years old. Secondly, according to the endometrial preparation protocols, the patients were divided into： natural cycle group （group A） and hormone replacement cycle group （group B）, the pregnancy outcome in the natural cycle and hormone replacement cycle in each age groups were compared. Results The clinical pregnancy rate of the two groups had significant difference （P 〈 0.05 ）. The clinical pregnancy rate of natural cycle decreased gradually as the age grow, however, the embryo implantation rate, clinical pregnancy and miscarriage rates of the two groups of patients in different age had no statistical significance （P 〉 0.05 ）. Conclusions It is more inclined to use hormone replacement cycle to prepare the endometrium for the older patients undergoing frozen-thawed embryo transfer.