冻融移植周期不同年龄组单囊胚与双卵裂期胚胎妊娠结局的比较

Comparison of Pregnancy Outcomes Between Single Blastocyst and Double Cleavage Stage Embryo Transfer in Different Age Groups

目的:研究冻融胚胎移植(frozen embryo transfer,FET)单囊胚移植(single blastocyst transfer,SBT)和双卵裂期胚胎移植(double cleavage stage embryo transfer,DET)在不同年龄组患者妊娠结局的差异。方法:将2017年1月-2018年12月在十堰市人民医院生殖医学中心首次进行胚胎移植的冻融胚胎移植周期(SBT 503个周期,DET 950个周期)1453个纳入研究。回顾性分析四个年龄组患者(21~25岁,26~30岁,31~35岁及≥36岁)在SBT和DET两种移植策略中的妊娠结局。结果:在FET周期中,四个年龄组患者的年龄、体质指数、不孕年限及基础性激素等临床特点两种移植策略无统计学差异(P>0.05)。四个年龄组中种植率、临床妊娠率、活产率及活单胎分娩率SBT组均明显高于DET组(P<0.05),而多胎率在四个年龄组均显著低于DET组(P<0.05)。结论:首次胚胎移植的患者在FET周期中,不同年龄组中SBT均比DET移植降低了多胎妊娠率及相关孕产期风险,同时具有更高的种植率、临床妊娠率和活产率,是一种值得推广的冻融胚胎移植策略。

Objective To study the difference in pregnancy outcomes of different age groups of patients between single blastocyst transfer(SBT)and double cleavage embryo transfer(DET)in freeze-thaw embryo transfer(FET).Methods From January 2017 to December 2018,1453 freeze-thaw embryo transfer cycles(SBT503 cycles,DET950 cycles)for the first embryo transfer in the Reproductive Medicine Center of Shiyan Renmin Hospital were included in the study.The pregnancy outcomes of four age groups(21~25 years old,26~30 years old,31~35 years old and≥36 years old)in SBT and DET transplantation strategies were analyzed retrospectively.Results In FET cycle,there was no significant difference in age,body mass index,infertility years and basic sex hormone of the four age groups between SBT and DET transplantation strategies(P>0.05).In the four age groups,the implantation rate,clinical pregnancy rate,live birth rate and single birth rate in SBT group were significantly higher than those in DET group(P<0.05),while the multiple pregnancy rate in SBT group was significantly lower than that in DET group(P<0.05).Conclusion Compared with DET transplantation,SBT can reduce the multiple pregnancy rate and related gestational risk in patients with first-time embryo transfer in FET cycle,and has higher implantation rate,clinical pregnancy rate and live birth rate,which is a worthy promotion strategy of frozen thawed embryo transfer.