D3/D5~6胚胎序贯移植对既往体外受精—胚胎移植失败患者冻融周期结局的影响

Effect of sequential transfer of day 3 and day 5~6 in the frozen-thawed cycles of patients with previous IVF-embryo transfer failure

目的通过比较D3/D5~6序贯移植、单囊胚移植、双囊胚移植与双卵裂期胚胎移植四种移植策略对既往体外受精—胚胎移植(IVF-ET)失败患者冻融胚胎移植(FET)周期妊娠结局的影响,探讨序贯移植是否能提高临床妊娠率。方法回顾性分析2019年7月~2020年8月既往IVF-ET失败,于我院行FET的451例患者临床资料。按不同移植策略分为A组(序贯移植组,45例);B组(单囊胚移植组,283例);C组(双囊胚移植组,46例);D组(双卵裂期胚胎移植组,77例)为对照组。结果A组临床妊娠率、胚胎种植率以及继续妊娠率均显著高于D组(75.56%vs 45.45%,52.22%vs 29.87%,94.12%vs 77.14%,P<0.05),多胎率未显著升高(P>0.05)。结论D3/D5~6序贯移植可以提高临床妊娠率及继续妊娠率,且不增加多胎风险,有助于改善既往IVF-ET失败患者冻融胚胎移植的妊娠结局。

Objective To compare the effect of sequential transfer of day 3 and day 5~6,single blastocyst transfer,double blastocysts transfer and double cleavage embryos transfer on the outcomes of frozen-thawed embryo transfer(FET)cycles in patients with previous in vitro fertilization and embryo transfer(IVF-ET)failures,and explore whether the sequential embryo transfer can improve the clinical pregnancy rate.Methods The clinical data of 451 patients with IVF-ET failed who underwent FET in our hospital from Jul 2019 to Aug 2020 were retrospectively analyzed.According to different transplantation strategies,they were divided into group A(sequential transfer,n=45),group B(single blastocyst transfer,n=283),group C(double blastocysts transfer,n=46),and group D(double cleavage embryos transfer,n=77).Group D was the control group.Results The clinical pregnancy rate,embryo implantation rate and continued pregnancy rate in group A were significantly higher than those in group D(75.56%vs 45.45%,52.22%vs 29.87%,94.12%vs 77.14%,P<0.05 for all),the multiple-pregnancy rate did not increase significantly(P>0.05).Conclusion Sequential transfer of day 3 and day 5~6 is helpful to improve the pregnancy outcome of FET in patients with previous IVF-ET failure by improving the clinical pregnancy rate and continued pregnancy rate without increasing the multiple-pregnancy rate.