首次冻融胚胎移植周期临床结局的影响因素

Analysis of factors influencing clinical outcomes in the first frozen-thawed embryo transfer cycles

目的分析在首次行冻融胚胎移植的患者中,影响冻融胚胎移植(FET)周期临床妊娠率和活产率的因素。方法回顾性分析1458例首次行FET周期助孕患者的临床数据,根据是否临床妊娠,分为临床妊娠组和未临床妊娠组;根据是否获得活产,分为活产组和未活产组。比较取卵时女方年龄、移植时女方年龄、体重指数、子宫内膜准备方案、子宫内膜厚度、胚胎移植数目和形态等临床数据,分析影响FET周期临床妊娠率和活产率的因素,并将这些因素纳入多因素logistic回归分析,确定影响FET周期临床妊娠率和活产率的独立因素。结果在1458个周期中,临床妊娠率为44.0%,活产率为34.0%。临床妊娠组和活产组移植时女方平均年龄分别明显小于未临床妊娠组和未活产组(P<0.05)。年龄<35岁患者的临床妊娠率和活产率均明显高于年龄≥35岁患者(P<0.05)。子宫内膜厚度≥8 mm患者的临床妊娠率和活产率均明显高于子宫内膜厚度<8 mm患者(P<0.05)。子宫内膜准备方案为自然周期的临床妊娠率明显高于激素替代周期(P<0.05)。2个胚胎移植的临床妊娠率和活产率均明显高于单胚胎移植(P<0.05)。囊胚移植的临床妊娠率和活产率均明显高于卵裂期胚胎移植(P<0.05)。多因素logistic回归分析发现,移植时女方年龄、子宫内膜厚度、移植胚胎数目和移植胚胎形态是FET周期临床妊娠率和活产率的独立影响因素。结论FET周期移植时女方年龄、子宫内膜厚度、移植胚胎数目和移植胚胎形态是临床妊娠和活产结局的独立影响因素。

Objective To analyze the influencing factors of clinical pregnancy and live birth rates in patients undergoing frozen-thawed embryo transfer(FET)for the first time.Methods The clinical data of 1458 patients who underwent FET cycle-assisted pregnancy for the first time were retrospectively analyzed and divided into four groups according to clinical pregnancy and live bith outcomes.The clinical data were compared to analyze the factors affecting clinical pregnancy and live birth rates in FET cycles that were included in multiple logistic regression analysis.Results Of the 1458 cycles,the clinical pregnancy and live birth rates were 44.0%and 34.0%,respectively.The mean age of the clinical pregnancy and live birth groups was lower than that in non-clinical pregnancy and stillbirth groups(P<0.05).The clinical pregnancy and live birth rates of patients aged<35 years were higher than those aged≥35 years(P<0.05).The clinical pregnancy and live birth rates of patients with≥8 mm endometrial thickness were higher than those with<8 mm endometrial thickness(P<0.05).The clinical pregnancy rate of natural cycles of endometrial preparation regimen was higher than that of HRT cycles(P<0.05).The clinical pregnancy and live birth rates of double-embryo transfers were higher than that of single-embryo transfers(P<0.05).The clinical pregnancy and live birth rates of blastocyst transfers were higher than those of cleavage stage(P<0.05).Conclusion Age,endometrial thickness,number of transplanted embryos,and embryo morphology were the independent factors influencing clinical pregnancy and live birth outcomes during FET cycle transplantation.