移植不同阶段冻融胚胎对异位妊娠风险的影响

The effect of developmental stage of transferred embryo on the risk of ectopic pregnancy in frozen-thawed cycle

目的比较冻融移植周期中囊胚期移植与卵裂期移植的异位妊娠风险。方法回顾性分析2013年1月至2014年9月期间,于解放军第一七四医院生殖中心实施冻融囊胚复苏移植及卵裂期胚胎复苏移植,并移植2枚复苏胚胎的患者的妊娠结局。结果冻融胚胎复苏移植2228周期中,共获得临床妊娠共1079例。在获得临床妊娠的患者中,囊胚期移植与卵裂期移植相比,年龄、移植周期数、移植深度、内膜厚度以及内膜类型,无统计学差异(P>0.05),而异位妊娠率显著下降(0.8%vs 3.4%,P<0.01)。通过多因素逻辑回归模型校正内膜因素的影响后,囊胚移植相对于卵裂期移植发生异位妊娠的风险比为0.204(0.072-0.578)。结论在冷冻复苏周期中行囊胚移植有利于减少异位妊娠率。

Objective：To compare the risk of ectopic pregnancy following blastocyst transfer with cleavage-stage embryo transfer in frozen thawed embryo transfer cycles. Methods：The study retrospectively analyzed pregnancy outcomes of patients who had received either thawed blastocyst transfer or thawed cleavage-stage embryo transfer and had two embryos transferred during the period from January 2012 to September 2014 in the Reproductive Medicine Center of 174 th hospital of PLA. Results：1079 pregnancies were achieved in 2228 transfer cycles. Among the women who had achieved a clinical pregnancy,there was no significant difference in the age at cycle start,the cycles of the transfer,the endometrial thickness or the pattern of endometrium between patients receiving blastocyst transfer and cleavage transfer（P-values〉0.05）. The incidence of ectopic pregnancy per clinic pregnancy in patients receiving blastocyst transfer was significantly lower than receiving cleavage transfer（0.8% vs 3.4 %,P〈0.01）. Adjusted for confounding factors,the adjusted risk ratio for ectopic pregnancy from blastocyst transfer compared with cleavage transfer was 0.204（0.072-0.578）. Conclusions：Transferring blastocyst in frozen thawed embryo transfer cycles might be helpful to reduce the risk of ectopic pregnancy.