含高浓度透明质酸移植液对IVF-ET临床结局的影响

Effect of high concentration hyaluronic acid transplant medium on clinical outcome of IVF-ET

目的探讨富含透明质酸的移植液EmbryoGlue对IVF-ET临床结局的影响。方法回顾性分析2018年8月至2019年1月在中山大学孙逸仙纪念医院生殖中心行IVF助孕的患者临床资料,共1207个周期。根据所用移植液不同分为EmbryoGlue组(n=596)和G2移植液组(n=611),比较两组的基本临床资料以及两组患者行卵裂期胚胎移植和囊胚移植的临床妊娠结局。结果两组患者整体的基本临床资料和临床结局均无显著性差异(P>0.05)。对于卵裂期胚胎移植,无论是新鲜胚胎移植还是冻融胚胎移植,EmbryoGlue组和G2组临床结局相似,无显著性差异(P>0.05)。对于囊胚移植的新鲜移植周期中,两组的临床结局无统计学差异(P>0.05);而在FET周期中,EmbryoGlue组的临床妊娠率(55.70%vs.43.95%)和种植率(45.66%vs.36.02%)均显著高于G2组(P<0.05),活产率有上升趋势(46.89%vs.36.31%),但差异无统计学意义(P>0.05)。结论EmbryoGlue未改善新鲜周期和FET周期的卵裂期胚胎移植结局,但是可以改善FET囊胚移植的临床结局。是否能够改善新鲜囊胚移植周期的临床结局,还需要大样本量的临床研究进行证实。

Objective:To explore the effect of hyaluronic acid as a transplant medium EmbryoGlue on IVF-ET clinical outcome.Methods:The clinical data of patients(1207 cycles)undergone assisted reproductive technology in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University from August 2018 to January 2019 were retrospectively analyzed.According to different transplant medium,they were divided into EmbryoGlue group(n=596)and G2 group(n=611).The basic clinical data and the clinical pregnancy outcomes of patients with cleavage embryo transfer and blastocyst transfer were compared between the two groups.Results:There were no significant differences in the overall basic clinical data and clinical outcomes between the two groups(P>0.05).For the cleavage stage embryo transfer,whether it was fresh embryo transfer or frozen-thawed embryo transfer,there was no significant difference in clinical outcomes between the EmbryoGlue group and G2 group(P>0.05).There was no significant difference in the clinical outcomes in the fresh blastocyst transfer cycle between the two groups.However,the clinical pregnancy rate(55.70%vs.43.95%)and implantation rate(45.66%vs.36.02%)of frozen-thawed blastocyst transfer in EmbryoGlue group were significantly higher than those in the G2 group(P<0.05).The live birth rate had an improvement trend(46.89%vs.36.31%),but the difference was not significant(P>0.05).Conclusions:EmbryoGlue medium does not improve the clinical outcomes of the cleavage stage embryo transfer both in fresh cycle and FET cycle,but improves the clinical outcomes of blastocyst transfer in FET cycles.Whether it can improve the clinical outcome of the fresh blastocyst transfer still needs to be confirmed by large sample size clinical studies.