新鲜周期和冻融周期胚胎移植术后发生异位妊娠的相关因素分析

Related factors for ectopic pregnancy after fresh versus frozen embryo transfer

目的比较新鲜周期和冻融周期胚胎移植后异位妊娠(EP)的发生率,探讨体外受精-胚胎移植(IVF-ET)后EP的危险因素。方法回顾性分析湘雅医院生殖医学中心2013年1月-2015年4月行IVF-ET或卵胞浆内单精子注射-胚胎移植(ICSI-ET)治疗的移植周期3 028例,其中新鲜移植周期1 696例,发生EP75例,冻融移植周期1 332例,发生EP 49例;比较两组患者的EP发生率,并探讨体外受精周期中发生EP的相关危险因素。结果冻融周期EP发生率为3.7%,新鲜周期EP发生率为4.4%,差异无统计学意义。盆腔输卵管病变、既往EP史、既往人工流产史、子宫内膜厚度及不孕类型是胚胎移植后EP发生的相关因素。结论冻融周期胚胎移植相比于新鲜周期,其EP发生率无明显降低。

Objective To investigate the ectopic pregnancy（EP） rate with fresh and frozen-thawed embryo transfers, and factors associated with ectopic pregnancy in patients undergoing in vitro fertilization and embryo transfer（IVF-ET）. Methods A total of 3,028 patients who underwent IVF-ET or intra-cytoplasmic sperm injection and embryo transfer（ICSI-ET） in Xiangya Hospital from January 2013 to April 2015 were analyzed retrospectively. Of the 1,696 women with fresh IVF transfer cycles（fresh transfer group）, 75 had an EP; while49 of the 1,332 women with frozen-thawed transfer cycles（frozen-thawed cycle group） had an EP. The incidences of EP were compared between both groups and the influential factors of EP were investigated. Results The incidence of EP per clinical pregnancy for the frozen-thawed cycle group and the fresh transfer group was 3.7% and 4.4% respectively; the difference was not statistically significant. The ectopic pregnancy was associated with pelvic oviduct disease, history of EP, history of artificial abortion, endometrial thickness and type of infertility. Conclusions The ectopic pregnancy rate of frozen-thawed embryo transfer is not lower than that of fresh transfer in patients undergoing IVF-ET.