冻融胚胎个体化移植方案的探讨

The individualized programs for frozen-thawed embryo transplantation

目的：分析若干因素对冻融胚胎移植临床妊娠率的影响。方法：回顾性分析截至2014年5月我院生殖医学中心3192例冻融胚胎移植患者的临床资料，按照年龄、不孕原因、不孕类型、不孕年限、给药方案、移植胚胎数目和时间进行分组，比较各组的临床妊娠率。结果：〈35岁组不孕妇女冻融胚胎移植临床妊娠率（33．96％）高于35．39岁组（27．58％）和〉39岁组（19．35％）（P〈0．05）、11盏床妊娠组的不孕年限小于未妊娠组（P〈0．05）、移植3个胚胎的临床妊娠率（41．01％）高于移植2个胚胎组（28．75％）（P〈0．05）、≥40岁冻融胚胎移植患者移植3个胚胎的临床妊娠率（25．49％）高于移植1个胚胎（0．00％）（P〈0．05）、冻融胚胎移植囊胚组临床妊娠率（40．00％）高于卵裂期组（26．27％）（P〈0．05）。结论：年龄、不孕年限、冷冻胚胎的移植数目和时间均可对冻融胚胎移植患者的临床妊娠率造成影响。结合年龄建立的个体化移植方案可以增加冻融胚胎移植患者的临床妊娠率。

Objective To analyze the influential factors of clinical pregnancy rate of the frozen-thawed embryo transplantation. Methods The data of 3 192 FET patients in the reproductive medicine center of our hospital up to May 2014 were analyzed retrospectively. According to ages, reasons of infertility, types of infertility, duration of infertility, drug regimen, the number and the time of embryo transplantation, we divided these patients into six groups for comparing the clinical pregnancy rate. Results The FET clinical pregnancy rate of the under 35 years group was higher than the 35 - 39 years group and the over 39 years group （33.96% vs. 27.58% and 19.35% ; P 〈 0.05, respectively）. The duration of infertility in the clinical pregnancy group was significantly shorter than the non- pregnancy group （P 〈 0.05）. The clinical pregnancy rate in the group with three embryos transplanted was higher than the group with only two embryos transplanted （41.01% vs. 28.75%; P 〈 0.05）. Among the group with the age of over 40 years, those with three embryos transplanted had a higher clinical pregnancy rate than those with only one embryo transplanted （25.49% vs. 0.00%; P 〈 0.05）. The clinical pregnancy rate of the frozen blastocyst transplantation group was higher than that of the cleavage-stage transplantation group （40.00% vs. 26.27%; P 〈 0.05）. Conehlsion Age, infertility duration, the number and the time of frozen embryo transplantation may affect the clinical pregnancy rate among the FET patients. An individualized transplantation program based on age may improve the patient＇s clinical pregnancy rate.