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冷冻单胚胎移植周期中活产的预测因素。

Predictive factors for live birth in cryopreservation single embryo transfer cycles.

作者信息

Olivius C, Lundin K, Bergh C

机构信息

Department of Endocrinology, Institute of Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

Reprod Biomed Online. 2008 Nov;17(5):676-83. doi: 10.1016/s1472-6483(10)60315-x.

Abstract

IVF cryopreservation cycles are known to be less successful than fresh cycles. The objective of this study was to investigate what variables, maternal and embryonic, that independently predict the live birth rate in cryopreservation single embryo transfers (SET). A retrospective analysis was performed on 622 cryopreservation SET originating from 371 consecutive patients performing 410 fresh cycles. Maternal and embryonic variables were analysed using logistic regression. The overall pregnancy and live birth rates were 22 and 16% respectively. Blastomere survival rate, number of previous fresh cycles and IVF as fertilization method compared with intracytoplasmic sperm injection (ICSI), were positive predictors of live birth. Number of embryos thawed to obtain one transfer was negatively associated with pregnancy rate but not with live birth rate. No statistical difference in live birth rate was found whether the couple had performed one, two or three failed cryopreservation cycles previously from the same egg retrieval. Knowledge of certain predictors for live birth contributes to the estimation of prognosis in cryopreservation SET, and is important when deciding whether to perform single or double embryo transfer in cryopreservation cycles. However, despite being independently associated with live birth and pregnancy, the predictive value of identified variables was low.

摘要

已知体外受精冷冻保存周期的成功率低于新鲜周期。本研究的目的是调查哪些母体和胚胎变量能独立预测冷冻保存单胚胎移植(SET)的活产率。对来自371例连续患者进行410次新鲜周期的622例冷冻保存SET进行了回顾性分析。使用逻辑回归分析母体和胚胎变量。总体妊娠率和活产率分别为22%和16%。卵裂球存活率、既往新鲜周期数以及与卵胞浆内单精子注射(ICSI)相比的体外受精作为受精方法,是活产的阳性预测因素。为获得一次移植而解冻的胚胎数量与妊娠率呈负相关,但与活产率无关。无论这对夫妇之前是否从同一取卵中经历过一次、两次或三次失败的冷冻保存周期,活产率均无统计学差异。了解某些活产预测因素有助于评估冷冻保存SET的预后,并且在决定冷冻保存周期中进行单胚胎移植还是双胚胎移植时很重要。然而,尽管所确定变量与活产和妊娠独立相关,但其预测价值较低。

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