新鲜胚胎移植和冻融胚胎移植用于OHSS高风险患者辅助妊娠的效果观察

Observation of the fresh embryo transfer and frozen thawed embryo transfer on the assisted pregnancy in patients with high risk of ovarian hyper stimulation syndrome

目的观察分析卵巢过度刺激综合征(OHSS)高风险患者行新鲜胚胎移植和冻融胚胎移植辅助妊娠后的临床效果。方法选取体外受精(IVF)及卵胞浆内单精子显微注射技术(ICSI)周期诊断为OHSS高风险的不孕患者130例,在给患者充分知情同意后由其选择新鲜胚胎移植或全胚冷冻后择期冻胚移植,分为鲜胚组67例和冻胚组63例,对比分析行不同移植技术后患者妊娠结局、新生儿质量和OHSS发病率方面的差异。结果对于OHSS高风险患者,冻胚组的种植率、妊娠率、活产率明显高于鲜胚组(P<0.05或P<0.01),而且OHSS发生率明显低于鲜胚组(P<0.05),早产率明显低于鲜胚组(P<0.05)。结论对于OHSS高危患者,应该采用全胚冷冻,再择期行冻胚移植,有助于提高胚胎移植的临床妊娠率、种植率与活产率,同时能降低OHSS患病率与早产儿发生率,值得临床推广应用。

Objective To observe and analyze the clinical effect of fresh embryo transfer and frozen thawed embryo transfer in patients with high risk of ovarian hyper stimulation syndrome( OHSS). Methods 130 patients with high risk of OHSS in IVF / ICSI treatment cycle were divided into fresh embryo transfer group( n = 67) and frozen thawed embryo transfer group( n = 63) under fully informed consent. Differences in outcome of pregnancy,neonatal quality and incidence of OHSS were compared. Results For patients at high risk of OHSS,the pregnancy rate and implantation rate,the live birth rate of the frozen embryo transplantation group was significantly higher than those of fresh embryo transfer group( P < 0. 01 or P < 0. 05),and the incidence of OHSS was significantly reduced( P < 0. 05). In addition,the preterm birth rate was significantly lower than that of the fresh embryo transfer group( P < 0. 05). Conclusion Patients at high risk of OHSS should use frozen embryo transplantation,which will improve embryo transplantation clinical pregnancy rate,implantation rate and live birth rate,but also can reduce OHSS incidence and the incidence of premature birth. So it is worth of clinical application.