鲜胚移植后累计妊娠率及其影响因素

Cumulative pregnancy rates after fresh embryo transfer and its influencing factors

目的探讨体外受精-胚胎移植妊娠结局及其影响因素。方法回顾性分析1660例鲜胚移植患者临床结局。根据是否临床妊娠分为妊娠组(A组)和非妊娠组(B组);根据冻胚移植结果,新鲜周期未获得活胎分娩的妇女分为妊娠组(C组)和未妊娠组(D组)。分析影响妊娠结局的相关因素。结果鲜胚移植临床妊娠率60.12%(998/1660),高于冻胚移植临床妊娠率53.15%(253/476)(P<0.05)。A组取卵个数、有效胚胎数、有效胚胎比例、内膜厚度及胚胎评分均高于B组(P<0.05)。C组有效胚胎数、有效胚胎比例、移植胚胎数均高于D组(P<0.05)。A组临床妊娠率高于C组(P<0.05)。第3次冻胚移植时临床妊娠率较第1、2次下降(P<0.05)。结论应争取鲜胚移植;但鲜胚移植失败患者仍有较高的冻胚移植成功率。2次冻胚移植失败后应考虑特殊原因引起的不孕,必要时重新取卵。

Objective To investigate the pregnancy outcomes and factors influencing on fertilization in vitro and embryo transfer （IVF-ET ） .Methods The pregnancy outcomes of 1660 women after fresh embryo IVF were analyzed ,who were divided into groups of A （got pregnant） and B （failed to get pregnant） .The women failed to get pregnant after fresh embryo transfer and had frozen embryo transfer were divided into groups of C （got pregnant） and D（failed to get pregnant） .The factors influencing on pregnancy outcomes were analyzed .Results The pregnancy rate was higher in women with fresh embryo IVF than that in those with frozen embryo transfer （60.12% vs .53.15% ） （P〈0 .05） .The numbers of egg and effective embryos ,effective embryo ratio ,endometrial thickness and embryo score in group A were higher than those in group B （P〈0 .05） .The number of effective embryos ,effective embryo ratio and the number of transferred embryos in group C were higher than those in group D（P〈0 .05） .The clinical pregnancy rate of group A was higher than that in group C （P〈0 .05） .The clinical pregnancy rate for the third time of frozen embryo transfer was significantly decreased（P〈0 .05） .Conclusion Fresh embryo transfer should be taken as the first choice .Frozen embryo transfer still has a higher success rate for fertilization .Some special causes of infertility should be considered in the cases failed to get pregnant after second frozen embryo transfer and the eggs should be taken again if necessary .