冻融胚胎移植在自然周期与人工周期中的临床结局分析

Clinical outcome of frozen-thawed embryo transfer in natural cycle and artificial cycle

目的探讨冻融胚胎移植时自然周期与人工周期对妊娠结局的影响。方法回顾性分析2012年3月至2014年6月在本中心进行冻融胚胎移植的411个周期,其中自然周期130个,人工周期281个。比较2组患者的年龄、不孕年限、基础内分泌水平、移植日子宫内膜厚度、移植胚胎质量和胚胎数、胚胎种植率、临床妊娠率、流产率等指标,并且对2组患者中继发不孕者的基本情况及临床结局进行比较。结果 2组的胚胎种植率、临床妊娠率、流产率分别是:自然周期组23.65%、47.69%、16.13%,人工周期组22.98%、43.77%、16.26%,差异均无统计学意义(P>0.05)。同时,2组中继发不孕者的基本情况及临床结局比较差异也无统计学意义(P>0.05)。结论在冻融胚胎移植中,自然周期和人工周期有相似的临床结局,应根据患者的具体情况选择更加适合的方案。

Objective To investigate the pregnancy outcome of frozen-thawed embryo transfer （F-ET） in natural cycle and artificial cycle. Methods A total of 411 patients underwent F-ET cycles in our center between March 2012 and June 2014 was retrospectively analyzed. There were 130 natural cycles and 281 artificial cycles. The age, infertility duration, basic endocrine level （FSH, LH, E2, and P）, endometrial thickness on transfer day, quality and number of transferred embryo, embryo implantation rate, clinical pregnancy rate, and abortion rate of patients between the natural cycle group and artificial cycle group were compared. Also, the basic condition and clinical outcome of the patients with secondary infertility between the two groups were compared. Results The implantation rate, clinical pregnancy rate, abortion rate were 23.65%, 47.69%and 16.13%in the natural cycle group, and 22.98%, 43.77%and 16.26%in the artificial cycle group, respectively, and there were no statistically significant differences between the two groups （P〉0.05）. At the same time, no statistically significant differences were found in the basic condition and clinical outcome of patients with secondary infertility between the two groups （ P〉0.05）. Conclusion There are similar clinical outcomes in F-ET between the natural cycle and artificial cycle. Therefore, a more suitable protocol should be used according to the specific condition of patients.