全胚冷冻在卵巢过度刺激高风险患者中的应用价值

The clinical significance of total embryo cryopreservation in IVF/ICSI-ET for patients with high risk of OHSS

目的比较对于体外受精/胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕后有卵巢过度刺激综合征(OHSS)高风险患者进行鲜胚移植或全胚冷冻后行冻胚移植,助孕结局的差异。方法回顾性分析我院2010年1月～2011年12月进行IVF/ICSI-ET助孕有OHSS高风险的患者共215例患者临床资料,比较鲜胚移植和全胚冷冻后行冻胚移植的两种处理方式的助孕结局。结果 152例鲜胚移植后的妊娠率、种植率、流产率分别为50.6%(77/152)、30.5%(101/331)、9.1%(7/77),59例全胚冷冻后行冻胚移植的妊娠率、种植率、流产率分别为66.1%(39/59)、40.6%(52/128)、10.3%(4/39)组间妊娠率和种植率均有统计学差异(P<0.05),流产率无统计学差异(P>0.05)。而且鲜胚移植组的OHSS发生率为8.6%,冻胚移植无1例OHSS发生。结论对于有OHSS风险的患者进行全胚冷冻并择期行冷冻胚移植,不仅可以大大减少OHSS的发生,而且可以获得更为理想的妊娠结局。

Objective：To compare the outcome between fresh embryo transfer and frozen embryo transfer after total embryo cryopreservation in IVF/ICSI-ET for patients with high risk of OHSS.Methods：A retrospective analysis of 215 patients with high risk of OHSS in IVF/ICSI-ET treatment cycle from January 2010 to December 2011 in our hospital was made.The patients were divided into two groups：152 fresh embryo transfer cycles（Group A）,and 59 all frozen embryo transfer cycles（Group B）,The clinical pregnancy outcomes were compared between the two groups.Result：Higher impanation rate and clinical pregnancy rate were revealed in Group B than those in Group A（P0.05）.Conclusion：Embryo transfer after all embryos cryopreservation in women with high risk of OHSS can get the better pregnancy outcomes and avoid the occurrence of severe OHSS effectively compared with transfer fresh embryos.