活性叶酸对中度风险叶酸代谢能力患者冻胚解冻移植助孕治疗的效果研究

Study on effect of active folic acid on pregnancy outcomes in patients with moderate risk of folate metabolic ability undergoing frozen embryo thawing transfer treatment

目的探究活性叶酸对行冻胚解冻移植(FET)助孕治疗的中度风险叶酸代谢能力患者妊娠结局的影响。方法回顾性分析2020年11月—2023年8月本院生殖中心行FET周期治疗的中度风险叶酸代谢能力患者(共337个周期)的临床资料。根据患者服用不同叶酸分为两组:服用活性叶酸的患者归为A组(n=185),服用普通叶酸的患者归为B组(n=152),比较两组间的基本资料及妊娠结局。结果两组间的年龄、抗缪勒管激素(AMH)、基础窦卵泡数(bAFC)、基础促卵泡素(bFSH)、不孕年限、体重指数(BMI)、移植日内膜厚度、服用叶酸前同型半胱氨酸(HCY)水平及移植的优质囊胚占比均无显著性差异(P>0.05);对于妊娠结局,两组间的临床妊娠率、早期流产率、晚期流产率、活产率、继续妊娠率及畸形率均无显著性差异(P>0.05)。结论对于中度风险叶酸代谢能力的育龄人群给予普通叶酸0.8 mg/d即可,补充活性叶酸无明显益处。

Objective To investigate the effect of active folic acid on pregnancy outcomes in patients with moderate risk of folate metabolic ability who receive frozen embryo thawing transfer(FET)treatment.Methods Clinical data of patients with moderate risk of folate metabolic ability who underwent FET cycle treatment in our reproductive center from November 2020 to August 2023(a total of 337 cycles)were retrospectively analyzed.Patients were divided into two groups according to different folic acid consumption:patients taking active folic acid were classified into group A(n=185),and patients taking ordinary folic acid were classified into group B(n=152).Basic data and pregnancy outcomes of the two groups were compared.Results There were no significant differences in age,anti-Müllerian hormone(AMH),basal antral follicle count(bAFC),basal follicle-stimulating hormone(bFSH),infertility duration,body mass index(BMI),endometrial thickness on the day of transfer,homocysteine(HCY)levels before folic acid supplementation,and the proportion of high-quality blastocysts transferred between the two groups(P>0.05).For pregnancy outcomes,there were no significant differences in clinical pregnancy rate,early miscarriage rate,late miscarriage rate,live birth rate,ongoing pregnancy rate,and malformation rate between the two groups(P>0.05).Conclusions For the population of reproductive age with moderate risk of folate metabolic ability,ordinary folic acid 0.8 mg/d is sufficient,and there is no significant benefit in supplementing with active folic acid.