自然周期冻融胚胎移植的影响因素分析

Influential factors of clinical pregnancy outcomes of women receiving natural cycle frozen-thawed embryo transfer

目的探讨影响自然周期冻融胚胎移植临床妊娠成功的因素。方法对南京市妇幼保健院生殖医学中心2011年1月至2013年12月行自然周期冻融胚胎移植治疗的282例患者的资料采用非条件Logistic回归分析法进行分析,并对回归分析的结果进行进一步的研究。结果患者年龄、卵泡排出时间(其中的hCG注射后24小时内排卵组)、移植不同发育阶段胚胎与妊娠结局相关(偏回归系数分别为:-0.052,0.446,-0.081,均P<0.05)。不孕年限、移植胚胎数目、子宫内膜厚度与妊娠结局无显著关系(均P>0.05)。肌注绒毛膜促性腺激素(hCG)后24小时内卵泡排出者临床妊娠率高于未注射hCG组及48小时内卵泡排出者(x^2值分别为3.880和4.660,均P<0.05)。移植囊胚与卵裂期胚胎相比,具有更高的临床妊娠率。结论年龄、卵泡排出时间、不同发育时期胚胎是影响自然周期冻融胚胎移植临床妊娠的重要因素。

Objective To investigate the influential factors of clinical pregnancy outcomes of women receiving natural cycle frozen-thawed embryo transfer. Methods Non-conditional Logistic regression analysis was conducted on the clinical data of 282 cases receiving natural cycle frozen-thawed embryo transfer during the period of January 2011 to December 2013 in Nanjing Maternal and Child Health Hospital. Results Patient’ s age, ovulation （ happened within 24 hours after hCG intramuscular injection ） and embryo at different stage were correlated with pregnancy outcomes （partial regression coefficient was -0. 052, 0. 446 and -0. 081, respectively, all P 〈0. 05）. Duration of infertility, endometrial thickness and the number of embryo transplantation had no relation with clinical pregnancy outcomes （all P〉0. 05）. Cases whose ovulation happened within 24 hours after hCG intramuscular injection got higher clinical pregnancy rate than that of the cases without hCG injection and those whose follicles discharged within 48 hours after hCG injection （χ2 value was 3. 880 and 4. 660, respectively, both P〈0. 05）. Besides, blastocysts were easier to grow compared with embryos at cleavage stage. Conclusion Age, the timing of ovulation and embryo at developmental stages are the key influential factors of natural cycle frozen-thawed embryo transfer.