行体外受精不孕女性新鲜周期与冻融周期胚胎移植后临床结局的比较

Comparison of clinical outcomes after embryos transfer of fresh versus frozen-thawed embryo

目的探讨不孕患者行体外受精后新鲜周期胚胎移植与冻融周期胚胎移植的临床结局。方法行体外受精-胚胎移植(in vitrofertilization and embryo transfer,IVF-ET)助孕女性10 921例,依据移植胚胎周期分为新鲜周期组6 367例(<35岁4 800例,≥35岁1 567例)和冻融周期组4 554例(<35岁3 689例,≥35岁865例)。比较2组胚胎移植后的临床妊娠结局。结果新鲜周期组胚胎移植数[(1.96±0.30)枚]、生化妊娠率(7.46%)、异位妊娠率(4.05%)均高于冻融周期组[(1.86±0.43)枚、5.37%、2.09%],临床妊娠率(43.83%)、活产率(38.07%)及新生儿体质量[(3 349.40±553.20)g]均低于冻融周期组[52.59%、44.64%、(3 511.20±593.60)g](P<0.05);新鲜周期组<35岁患者胚胎移植数[(1.91±0.28)枚]、生化妊娠率(7.43%)、异位妊娠率(3.84%)均高于冻融周期组[(1.79±0.41)枚、4.86%、1.71%],临床妊娠率(48.27%)、流产率(11.48%)、早期流产率(7.29%)、活产率(42.73%)均低于冻融周期组(55.22%、14.28%、9.18%、47.33%)(P<0.05);新鲜周期组≥35岁患者胚胎移植数[(2.18±0.38)枚]高于冻融周期组[(2.10±0.30)枚],临床妊娠率(30.25%)、活产率(23.04%)均低于冻融周期组(41.39%、33.18%)(P<0.05)。结论冻融胚胎移植可提高临床妊娠率、活产率及新生儿体质量,降低生化妊娠率、异位妊娠率。

Objective To explore the clinical outcomes of fresh embryo transfer and frozen-thawed embryo transfer in infertile patients after in vitro fertilization.Methods Totally 10 921 women undergoing in vitro fertilization-embryo transfer were divided into fresh embryo group（n=6 367）including 4 800 women aged〈35 years and 1 567 women aged≥35 years,and frozen-thawed embryo group（n=4 554）including 3 689 women aged〈35 years and 865 women aged≥35 years）.The clinical pregnancy outcomes were compared between two groups.Results The number of embryo transfer（1.96±0.30）,biochemical pregnancy rate（7.46%）and ectopic pregnancy rate（4.05%）in fresh embryo group were significantly higher than those in frozen-thawed embryo group（1.86±0.43,5.37%,2.09%）（P〈0.05）,and the clinical pregnancy rate（43.83%）,live birth rate（38.07%）and neonatal body mass（（3 349.40±553.20）g）were significantly lower than those in frozen-thawed embryo group（52.59%,44.64%,（3 511.20±593.60）g）（P〈0.05）.The number of embryo transfer（1.96±0.28）,biochemical pregnancy rate（7.43%）and ectopic pregnancy rate（3.84%）in fresh embryo group were significantly higher than those in frozen-thawed embryo group（1.79±0.43,4.86%,1.71%）in patients aged35 years（P〈0.05）,while the clinical pregnancy rate（48.27%）,abortion rate（11.48%）,early abortion rate（7.29%）and live birth rate（42.73%）were significantly lower than those in frozen-thawed embryo group（55.22%,14.28%,9.18%,47.33%）（P〈0.05）.The number of embryo transfer（2.18±0.38）was significantly higher,and the clinical pregnancy rate（30.25%）and live birth rate（23.04%）were significantly lower in fresh embryo group than those in frozen-thawed embryo group（2.10±0.30,41.39%,33.18%）in patients aged ≥35 years（P〈0.05）.Conclusion Frozen-thawed embryo transfer can significantly improve the clinical pregnancy rate,live birth rate and neonatal body mass,as well as reduce the biochemical pregnancy rate and ectopic pregnancy rate.