新鲜周期与复苏周期囊胚移植效果的历史性队列研究

Clinical outcome of fresh or frozen-thawed blastocyst transfer:a historic cohort study

目的比较新鲜周期和复苏周期囊胚移植的相关参数及其临床结局。方法采用历史性队列研究方法,将2015年3月—2016年12月在第二军医大学长海医院生殖医学中心接受助孕治疗的患者分为新鲜周期囊胚移植组(61例)和复苏周期囊胚移植组(372例),收集其临床结局资料,比较两组患者的囊胚种植率和临床妊娠率。根据移植天数将复苏周期囊胚移植组分为第5天组(n=308)和第6天组(n=64)2个亚组,分析其临床结局的差异。结果新鲜周期和复苏周期囊胚移植组患者的年龄和移植囊胚数差异均无统计学意义,复苏周期囊胚移植组患者的囊胚种植率高于新鲜周期囊胚移植组(40.2%vs 29.6%,P=0.036),但两组患者的临床妊娠率差异无统计学意义(57.8%vs 47.5%,P=0.134)。复苏周期囊胚移植第5天组患者的囊胚种植率和临床妊娠率均高于第6天组(囊胚种植率42.3%vs 30.1%,P=0.016;临床妊娠率60.7%vs 43.8%,P=0.012)。结论复苏周期囊胚移植可比新鲜周期囊胚移植获得更好的妊娠结局,且第5天移植者比第6天移植者效果更佳。

Objective To explore the relevant parameters and clinical outcome of frozen-thawed blastocyst transfer compared with fresh blastocyst transfer.Methods A historic cohort study was conducted to analyze the blastocyst implantation rate and clinical pregnancy rate of 61 patients receiving fresh blastocyst transfer and 372 receiving frozenthawed blastocyst transfer from Mar.2015 to Dec.2016 in Changhai Hospital of Second Military Medical University.And then the clinical outcomes of day five（n=308）or day six（n=64）embryo were analyzed in the frozen-thawed blastocyst transfer group.Results There was no significant difference in age or number of the transferred blastocysts between the two groups.Blastocyst implantation rate in frozen-thawed blastocyst transfer group was significantly higher than that in fresh blastocyst transfer group（40.2% vs 29.6%,P=0.036）,while no significant difference was found in clinical pregnancy rate between the two groups（57.8% vs 47.5%,P=0.134）.Blastocyst implantation rate and clinical pregnancy rate of day five embryo were significantly higher than those of day six（42.3% vs 30.1%,P=0.016,and60.7% vs 43.8%,P=0.012,respectively）.Conclusion The pregnancy outcome of frozen-thawed blastocyst transfer is better compared with fresh blastocyst transfer,especially when transferring on day five.