40岁以下女性新鲜周期与冷冻周期第5天单囊胚移植的临床结局比较

Comparison of Clinical Outcomes of Single Blastocyst Transfer on Day 5 between Fresh Cycles and Frozen-thawed Cycles in Women Aged Under 40

目的探讨40岁以下女性新鲜周期与冷冻周期第5天单囊胚移植对临床结局的影响。方法回顾性分析2016年1月至2018年12月中国医科大学附属盛京医院生殖医学中心行第5天单囊胚移植的995例40岁以下女性患者的临床资料,其中新鲜移植周期180个(新鲜周期组)、冷冻移植周期815个(冷冻周期组),比较两组的妊娠结局和新生儿结局。结果妊娠结局比较中,新鲜周期组临床妊娠率显著低于冷冻周期组[54.44%(98/180)比66.63%(543/815)](P<0.01),两组活产率、早产率、异位妊娠率以及多胎妊娠率比较差异无统计学意义(P>0.05)。新生儿结局比较中,新鲜周期组平均出生体重显著低于冷冻周期组[(3284±543)g比(3424±610)g](P<0.05),两组平均孕周、低出生体重比例、出生缺陷比例、新生儿死亡比例比较差异均无统计学意义(P>0.05)。结论40岁以下女性第5天单囊胚移植中,与新鲜周期相比,冷冻周期有相似的活产率并能改善新生儿结局。

Objective To explore the effect of day 5 single blastocyst transfer on the clinical outcomes between fresh and frozen-thawed cycles in women aged under 40.Methods The data of 995 cases of women aged under 40 undergoing fresh and frozen-thawed day 5 single blastocyst transfer in the Reproduction Medicine Center of Shengjing Hospital Affiliated to China Medical University between Jan.2016 and Dec.2018 were retrospectively analyzed.Fresh single blastocyst transfer group included 180 cases,whereas those frozen-thawed single blastocyst group included 815 cases.Te pregnancy and neonatal outcomes of the two groups were compared.Results In the comparison of pregnancy outcome,the clinical pregnancy rate in the fresh cycle group was significantly lower than that in the frozen-thawed cycle group[54.44%(98/180)vs66.63%(543/815)](P<0.01).The live birth rate,preterm birth rate,ectopic pregnancy rate and the multiple pregnancy rate were not statistically significantly different between the two groups(P>0.05).In the comparison of neonatal outcome,the mean birth weight of the fresh cycle group was significantly lower than that of the frozen-thawed cycle group[(3284±543)g vs(3424±610)g](P<0.05),while the mean gestational age,low-birth-weight rate,birth defects rate and neonatal death rate had no statistically significant difference(P>0.05).Conclusion Compared with the fresh cycle,the frozen-thawed cycle has similar live birth rate and can improve the neonatal outcomes of day 5 single blastocyst transfer in women aged under 40.