阿托西班对不同年龄子宫内膜异位症不孕患者行解冻胚胎移植妊娠结局的影响

Influence of atosiban on pregnancy outcome in infertility patients with endometriosis of different ages in frozen-thawed embryo transfer

目的探讨不同年龄子宫内膜异位症不孕患者行解冻胚胎移植(F-ET)术前使用阿托西班对其妊娠结局的影响。方法回顾性分析行F-ET的子宫内膜异症不孕患者,共684例。根据F-ET日是否使用阿托西班分为观察组和对照组,观察组(329例)于移植前0. 5 h静脉推注小剂量阿托西班(6. 75 mg/0. 9 ml),对照组(355例)未使用阿托西班。因年龄是影响妊娠结局的重要因素,因此将观察组与对照组以35岁为界再次分组,分析比较不同年龄组中观察组与对照组间的胚胎着床率、生化妊娠率、临床妊娠率、流产率及活产率之间的差异。结果不同年龄组中观察组的胚胎着床率、生化妊娠率、临床妊娠率及活产率均显著高于对照组,差异有统计学意义(P <0. 05);≤35岁年龄组中观察组流产率明显低于对照组,差异有统计学意义(P=0. 02)。多因素分析结果显示,使用阿托西班、患者年龄和移植胚胎数对妊娠结局有影响。使用阿托西班(OR=4. 04,P <0. 01)、移植胚胎数(OR=1. 87,P <0. 01)是临床妊娠率的提高因素,患者年龄(OR=0. 62,P=0. 04)是临床妊娠率的降低因素。结论不同年龄子宫内膜异位症不孕患者在F-ET日移植前给予小剂量阿托西班预处理可明显改善其临床妊娠结局。

Objective To investigate the influence of atosiban on frozen-thawed embryo transfer(F-ET)pregnancy outcome in infertility patients with endometriosis of different ages.Methods This study was conducted on 684 women with infertility patients with endometriosis in different ages undergoing F-ET.Then were divided into two group:study group with a single bolus dose(6.75 mg/0.9 ml,iv)of atosiban before F-ET(n=329),and control group without atosiban(n=355).Results The embryo implantation rate,bioche-mical pregnancy rate,clinical pregnancy rate and living-birth rate of study group were significantly higher than those of control group(P<0.05).The abortion rate of study group whose age was less than or equal to 35 was lower than that of control group(P<0.05).The abortion rate of study group who was older than 35 was lower than those of control group,but there was no statistical difference(P>0.05).The use of atosiban(OR=4.04,P<0.01)and the number of transplanted embryos(OR=1.87,P<0.01)were the factors to improve the clinical pregnancy rate.The pregnancy rate was declining with age(OR=0.62,P=0.04).Conclusion Pretreatment with atosibanbefore embryo transfer may improve pregnancy outcomes of infertility patients with endometriosis of different ages in F-ET.