体外受精中新鲜移植周期早期流产临床相关性数据分析

Early abortion related factors of fresh embryo transplant in vitro fertilization

目的分析研究体外受精胚胎移植及卵胞浆单精子显微注射（IVF-ET/ICSI）技术助孕后发生早期流产的相关临床因素。方法选取2013年1月-2015年8月进行IVF-ET/ICSI治疗后新鲜移植周期并临床妊娠202例,妊娠结局分为早期流产组和继续妊娠组,分析比较组间相关临床资料。结果 IVF-ET/ICSI助孕治疗新鲜周期移植后流产率为13.86%。早期流产组在女方年龄,不孕年限,降调总量,促性腺激素（Gn）总量、使用天数,Gn启动日促卵泡成熟激素（FSH）、促黄体生成素（LH）、雌二醇（E2）水平,注射人绒毛膜促性腺激素（HCG）日卵泡数、E2、LH、孕酮（P）水平,获卵数,MII卵子成熟率,总受精率,移植胚胎数,优胚率,囊胚形成率和着床率,用药方案,是否添加LH,受精方式与继续妊娠组相比,差异均无统计学意义（P〉0.05）。早期流产组胚胎绒毛染色体检测异常率为66.67%。结论 IVF-ET/ICSI中早期流产主要因素为胚胎染色体异常遗传因素,而与其他临床及治疗因素无关,须扩大样本量来进一步研究。

Objective To analyze impact factors after in vitro fertilization and embryo transfer and intracytoplasmic sperm injection treatment of early abortion. Methods Two hundred and two pregnancy cases of fresh transfer after IVF-ET / ICSI treatment were collected,pregnancy outcome were divided into group of early abortion and the group of continued pregnancy,and clinically relevant data were compared between the two groups. Results The abortion rate was 13. 86% in fresh transfer after IVF-ET / ICSI treatment. The difference of age of the woman,duration of infertility,total dose of down-regulation,Gn total dose,Gn injection days,levels of FSH / LH /E2 on Gn start date,number of follicles on HCG injection day,levels of E2/ LH / P,oocytes number,MII oocyte maturation rate,total fertility rate,number of transplanted excellent embryos,embryo with quality rate,blastocyst formation rate,implantation rate. chelating regimens,whether to add LH and fertilization way in both groups was not statistically significant（ P〈0. 05）. Chromosome abnormality ratio of early abortion group was 66. 67%. Conclusion The main impact factor is genetic embryonic chromosomal abnormalities in early abortion of IVF-ET / ICSI,and other factors need to expand the sample size to further studies.