宫腔镜检查距胚胎移植的间隔时间与鲜胚移植周期妊娠结局的相关性研究

Association between the time interval after hysteroscopy and pregnancy outcomes during fresh embryo transfer cycles.

目的:探讨行宫腔镜检查距胚胎移植的时间间隔与鲜胚移植周期妊娠结局的相关性。方法:回顾分析山东大学附属生殖医院自2017年7月至2018年12月行第1周期IVF或ICSI助孕并行鲜胚移植患者的临床资料。3772例宫腔镜检查未见明显异常的患者中,根据宫腔镜距胚胎移植的时间间隔分组,组1为宫腔镜检查术后第1个月经周期行鲜胚移植的患者(时间间隔24~53d),组2为术后第2个月经周期行鲜胚移植的患者(时间间隔54~84d),组3为术后第3个月经周期后行鲜胚移植的患者(时间间隔≥85d),比较组间妊娠结局差异。结果:3组的临床妊娠率分别为54.9%、54.2%、52.9%(P=0.628),活产率分别为47.6%、46.1%、45.0%(P=0.432)。多因素logistic回归分析结果表明,宫腔镜检查距鲜胚移植的间隔时间与临床妊娠率及活产率无明显相关性。结论:行IVF或ICSI助孕的患者,如宫腔镜检查无异常,检查术后第1个月经周期进行鲜胚移植与间隔更长时间移植的妊娠结局无明显差异。

Objective:To investigate whether the time interval between hysteroscopy and fresh embryo transfer were associated with the pregnancy outcomes.Methods:The clinical data of patients who underwent their first cycles of IVF with or without ICSI at the Reproductive Medical Center of Shandong University from July 2017 to December 2018 were retrospectively analyzed.In 3772 patients with no apparent intrauterine cavity abnormalities on hysteroscopy,they were classified by three groups based on the time interval between hysteroscopy and fresh embryo transfer:group 1(patients who underwent fresh embryo transfer within the first menstrual cycle after hysteroscopy,24 to less than 53 days),group 2(patients who underwent fresh embryo transfer after the second menstrual cycle after hysteroscopy,54 to less than 84 days),group 3(patients who underwent fresh embryo transfer after more than the third menstrual cycles after hysteroscopy,more than 85 days).The pregnancy outcomes after fresh embryo transfer were compared among the three groups.Results:The clinical pregnancy rates(54.9%,54.2%,and 52.9%,P=0.628),and the live birth rates(47.6%,46.1%,and 45.0%,P=0.432)were comparable among these three groups.Multivariate logistic regression analysis showed that no statistically significant association between the interval group and the rates of clinical pregnancy and live birth was observed.Conclusion:For women who undergo IVF and with no abnormalities on hysteroscopy,there are no significant differences in pregnancy outcomes between women undergo fresh embryo transfer in the first menstrual cycle after hysteroscopy and those with longer intervals between hysteroscopy and fresh embryo transfer.