阿托西班对体外受精-胚胎移植结局影响

Effects of Atosiban on clinical outcomes of in vitro fertilization-embryo transfer: a retrospective cohort study

目的探讨阿托西班对体外受精-胚胎移植妊娠率和种植率的影响。方法回顾性分析自2013年1月至2014年8月于中国医科大学附属盛京医院接受体外受精-胚胎移植助孕治疗的1 804例患者的临床资料。将患者分入阿托西班组(n=1 051)和常规组(n=753),比较两组患者的妊娠率、种植率、活产率、多胎妊娠率、流产率及异位妊娠率。再将两组患者分别按照年龄(年龄<40岁和年龄≥40岁)、胚胎质量(优质胚胎和非优质胚胎)、周期数(周期数<3次和周期数≥3次)分入亚组,比较不同亚组患者的妊娠率。结果阿托西班组的妊娠率和种植率均明显高于常规组,差异有统计学意义(P<0.05);两组间活产率、多胎妊娠率、流产率及异位妊娠率差异无统计学意义(P>0.05)。在<40岁亚组和优质胚胎亚组中,阿托西班组的妊娠率均明显高于常规组,差异有统计学意义(P<0.05);在年龄≥40岁亚组、非优质胚胎亚组、周期数<3次亚组及周期数≥3次亚组中,阿托西班组和常规组的妊娠率差异无统计学意义(P>0.05)。结论对于年龄<40岁、移植优质胚胎的患者,阿托西班可明显提高体外受精-胚胎移植的妊娠率和种植率。

Objective To evaluate the effect of atosiban administration during embryo transfer on the pregnancy and implantation rate of in vitro fertilization-embryo transfer. Methods A retrospective study was performed on 1 804 cases of patients who underwent in vitro fertilization-embryo transfer from January 2013 to August 2014. Patients were divided into the atosiban group（ n = 1 051） and the conventional group（ n = 753）. The clinical pregnancy rate,impantation rate,live birth rate,multiple pregnancy rate,miscarriage rate and ectopic pregnancy rate between the two groups were analyzed. Patiens were divided into the subgroups according to the age（ less than 40 and more than 40）,embryo quality（ high quality and non-prime quality） and the number of cycles（ less than 3 times and more than 3 times）,pregnancy rates were compared between the patients in subgroups. Results The pregnancy rate and implantation rate in atosiban group was significantly higher than that in the conventional group（ P 〈 0. 05）. There was no statistically significant difference in the live birth,multiple pregnancy rate,miscarriage and ectopic pregnancy rates between the two groups（ P 〉 0. 05）. In the subgroups of less than 40 years old and high quality,the pregnancy rates in the atosiban group were significantly higher than those in the conventional group（ P 〈 0. 05）; in the subgroups of more than 40 years old,non-prime quality,less than 3 times and more than 3 times,the pregnancy rates had no statistically significant difference between the atosiban group and the conventional group（ P 〉 0. 05）.Conclusion Atosiban can significantly improve the clinical pregnancy rate and implantation rate of in vitro fertilization-embryo transfer in patients aged less than 40 years old and with high quality embryos transferred,and the beneficial effect is remarkable.