摘要
目的评价全胚冷冻技术对活产率和卵巢过度刺激综合征(OHSS)发生的影响。方法选取2013年1月至2017年12月该院行体外受精-胚胎移植且取卵数大于或等于15个的患者2983例,其中行全胚冷冻患者1036例为研究组,行新鲜周期移植患者1947例为对照组。比较两组患者的一般临床基线资料、累积活产率(CLBR)和OHSS发生率,进行研究组CLBR的logistic多因素分析。结果采取1∶1倾向性评分匹配后两组患者均为516例,其年龄、不孕因素、基础卵泡刺激素水平、BMI等比较差异无统计学意义(P>0.05),研究组获卵数多于对照组,差异有统计学意义(P<0.05)。倾向性评分匹配后研究组无OHSS发生,对照组有9例,差异有统计学意义(P=0.007)。研究组各移植周期中CLBR高于对照组,但只有第1个移植周期差异有统计学意义(P<0.05)。多因素logistic回归分析显示,获卵数和年龄是CLBR的重要预测指标。结论优先选择全胚冷冻可有效降低发生OHSS的可能,并获得更高的CLBR。
Objective To evaluate the effect of whole embryo freezing technology on the live birth rate and ovarian hyperstimulation syndrome(OHSS).Methods A total of 2983 cases of patients undergoing in vitro fertilization-embryo transfer(IVF-ET)with number of oocytes retrieved≥15 in this hospital from January 2013 to December 2017 were selected,among them 1036 cases of whole embryo cryopreservation served as the study group and 1947 cases of fresh cycle transplantation as the control group.The general clinical baseline data,cumulative live birth rate(CLBR)and OHSS occurrence rate were compared between the two groups,and the logistic multivariate analysis of CLBR in the study group was carried out.Results There were 516 cases in the two groups after 1∶1 propensity score matching.There was no statistically significant difference in the age,infertility factors,basal FSH level,BMI,etc.(P>0.05);the number of oocytes retrieved in the study group was more than that in the control group,and the difference was statistically significant(P<0.05).The study group had no OHSS occurrence after propensity matching,while there were 9 cases in the control group,and the difference was statistically significant(P=0.007).CLBR in each transplantation circle in the study group was higher than that in the control group,but the difference only in the first transplantation cycle had statistical significance(P<0.05).The multivariate logistic regression analysis showed that the number of oocytes retrieved and age were the important predictive factors of CLBR.Conclusion The preference selection of whole embryo freezing can effectively reduce the possibility of OHSS and obtain higher CLBR.
作者
王春利
施文浩
徐洁
WANG Chunli;SHI Wenhao;XU Jie(Reproductive Center,Northwest Women′s and Children′s Hospital,Xi′an,Shaanxi 710003,China)
出处
《重庆医学》
CAS
2021年第7期1182-1186,共5页
Chongqing medicine
关键词
体外受精胚胎移植术
全胚冷冻
累积活产率
卵巢过度刺激综合征
in vitro fertilization and embryo transfer
whole embryo freezing
cumulative live birth rate
ovarian hyperstimulation syndrome