单囊胚复苏移植中不同年龄妇女妊娠结局的比较

Clinical outcome of frozen-thawed single blastocyst transfer in women with different age

目的探讨冻融单囊胚移植周期中年龄对妊娠结局的影响。方法回顾性分析本院生殖中心2008年1月至2015年12月行冻融优质单囊胚移植的1 005个周期的临床妊娠结局,根据患者年龄分为4组:A组:≤29岁(n=296);B组:30~34岁(n=389);C组:35~37岁(n=151);D组:≥38岁(n=169)。比较4组的临床结局,探讨年龄对妊娠结局的影响。结果 4组临床妊娠率、单胎妊娠率、双胎妊娠率、异位妊娠率、晚期流产率及早产率均无统计学差异(P>0.05);与A、B、C组相比较,D组的早期流产率、足月产率及活产率差异有统计学意义(P<0.01)。A至D组,早期流产率呈递增趋势,足月产率和活产率呈递减趋势。在年龄≥38岁组,早期流产率高达38.82%,足月产率41.18%,活产率仅有25.44%。结论年龄≥38岁的患者行优质单囊胚移植,妊娠率与其它年龄组无差异,早期流产率明显升高,足月产率及活产率明显降低,建议行双囊胚移植。

Objective: To compare the clinical outcome of frozen-thawed single blastocyst transfer in women with different age.Methods: The clinical data of single frozen-thawed blastocyst transfer cycles of 1005 patients in Reproductive Medicine Center,Jinjiang Maternal and Child Health Hospital from January 2008 to December 2015 was retrospectively analyzed.All patients were divided into four groups by age:the patients' age≤29years in group A(n=296),the patients' age from 30 to 34years in group B(n= 389),the patients' age from 35 to 37years in group C(n=151),the patients' age≥38years in group D(n=169).The clinical outcomes were compared among the four groups.Results: There were no significant differences in the clinical pregnancy rate,single pregnancy rate,twin pregnancy rate,ectopic pregnancy rate,the late abortion rate and preterm birth rate among the groups.The early abortion rate had increasing trend,and the full-term birth rate & live birth rate had decreasing trend from group A to group D.In the group of women ages≥38years,early abortion rate was38.82%,full-term birth rate 41.18% and live births rate only 25.44%.Conclusions: The pregnancy rate of frozen-thawed single blastocyst transfer in women aged≥38years is not different with the younger women,but their early abortion rate is significant increased and full-term birth rate and live birth rate are significant decreased,so double blastocyst transfer should be considered for them.