不同胚胎移植策略对反复种植失败患者临床结局的影响

Effects of different embryo transfer strategies on clinical outcomes of patients with recurrent implantation failure

目的探讨不同胚胎移植策略对反复种植失败患者临床结局的影响。方法回顾性分析2018年12月—2020年11月在宁波市妇女儿童医院生殖医学中心行辅助生殖技术(ART)助孕治疗,既往有反复种植失败史,拟再次行冻融胚胎移植患者共231例。根据不同胚胎移植策略分为序贯移植组(55例)、囊胚移植组(56例)及卵裂期胚胎移植组(120例)。分析比较3组患者临床结局(临床妊娠率、早期流产率、多胎率、活产率)。结果序贯移植组临床妊娠率(70.91%)高于囊胚移植组(57.45%)和卵裂期胚胎移植组(50.00%),差异均有统计学意义(P<0.05)。序贯移植组活产率(58.18%)高于囊胚移植组(51.79%)和卵裂期胚胎移植组(40.83%),但差异均无统计学意义(P>0.05)。3组间早期流产率及多胎率比较,差异无统计学意义(P>0.05)。结论序贯移植可以提高反复种植失败患者的临床妊娠率及活产率,且不增加多胎率及早期流产率。序贯移植可作为反复种植失败患者的有效治疗手段。

Objective To investigate the effects of different embryo transfer strategies on clinical outcomes of patients with recurrent implantation failure.Methods Total 231 patients with recurrent implantation failure who accepted frozen-thawed embryo transfer were analyzed retrospectively from December 2018 to November 2020.According to different embryo transfer strategies,they were divided into three groups:sequential embryo transfer group(55 cases);Blastocyst transfer group(56 cases);Cleavage embryo transfer group(120 cases).The clinical outcomes(clinical pregnancy rate,early abortion rate,multiple pregnancy rate,live birth rate)were compared among three groups.Results The clinical pregnancy rate of sequential transfer group(70.91%)was higher than that of blastocyst transfer group(57.45%)and cleavage embryo transfer group(50.00%),the difference was statistically significant(P<0.05).The live birth rate of sequential transfer group(58.18%)was higher than that of blastocyst transfer group(51.79%)and cleavage embryo transfer group(40.83%),but the difference has no statistically significant(P>0.05).There was no significant difference in the early abortion rate and multiple pregnancy rate among the three groups(P>0.05).Conclusion Sequential embryo transfer can effectively improve the clinical pregnancy rate of patients with recurrent implantation failure,without increasing early abortion rate and multiple pregnancy rate.Sequential embryo transfer can be used as an effective treatment for recurrent implantation failure patients.