影响胚胎反复移植失败患者妊娠结局的相关因素分析

The related factors affecting the pregnancy outcomes of patients with repeated implantation failure in frozen-thawed embryo transfer cycle

目的:回顾分析影响胚胎反复移植失败(RIF)患者冷冻周期移植(FET)妊娠结局的相关因素。方法:回顾性分析行IVF-ET失败3次及3次以上的患者共581个冷冻移植周期,采用单因素及多因素Logistic回归分析年龄、不孕年限、RIF次数、平均移植优胚数及类型、内膜准备方案、基础FSH、移植日(子宫内膜厚度、E2、P,E2与P的比值)各项因素与妊娠结局的相关性。结果:妊娠组年龄明显低于未妊娠组(33.89±4.20&35.50±5.06)(Ρ<0.05);妊娠组平均每周期移植胚胎数(1.94±0.519&1.88±0.281)及移植囊胚周期数(21.03%&12.81%)均多于未妊娠组,移植2个与移植3个的妊娠率及多胎率无明显差异(P>0.05)。logistic回归分析年龄、移植优胚数量及类型与妊娠具有相关性(P<0.05)。结论:在FET周期中,对于高龄RIF患者,移植2个或以上囊胚,对提高妊娠率具有积极意义。

Objective To analyze the related factors affecting the pregnancy outcomes of patients with repeated implantation failure （RIF） in frozen-thawed embryo transfer （FET） cycle. Methods Clinical data of 581 FET cycles with 3 or more than 3 times of iailures in previous IVF/ICSI-ET was analyzed. The correlations between pregnancy outcomes and age, duration of infertility, number of RIF, average number of transferred high quality embryos, type of transferred high quality embryos, endometrial thickness on transfer day, basal FSH level, E2 level on transfer day, P level on transter day, E2/P on transfer day, were assessed by univariate and multivariate Logistic regression. Results The age of patients in pregnant group was lower than that in non-pregnant group [ （33.89 -＋ 4.20） years vs. （35.50 -＋ 5.06） years, P 〈 0.05]. The number of transferred embryos in each cycle and cycles of blastocyst FET in pregnant group were significantly higher than those in non-pregnant group, respectively [1.94 ± 0.519 vs. 1.88 ± 0.281; 21.03% vs. 12.81% ]. Biochemical pregnancy rate and muhiple pregnancy rate showed no significant difference between transibr of 2 embryos and transfer of 3 embryos （P 〉 0.05）. Age and number and type of high-quality embryos transferred were significantly related to the pregnant outcomes （P 〈 0.05）. Conclusion In the FET cycle, for the RIF-patients no less than 38 years old, to transfer more than 2 blastoeyst was meaningful.