冻融胚胎移植方案可提高胚胎利用率。

A frozen-thawed embryo transfer program improves the embryo utilization rate.

机构信息

Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China.

出版信息

Chin Med J (Engl). 2009 Sep 5;122(17):1974-8.

PMID:19781380

Abstract

BACKGROUND

Frozen-thawed embryo transfer (FET) is the most common way to prevent serious late ovarian hyperstimulation syndrome and increase the cumulative pregnancy rate. We evaluated the effectiveness of an FET program for improving the embryo implantation and clinical pregnancy rates, and ultimate embryo utilization rate in infertility treatment.

METHODS

Patients undergoing in vitro fertilisation (IVF) cycles from January 2006 to June 2008 were enrolled, including 179 patients who had undergone the first FET cycle after controlled ovarian hyperstimulation (COH) in which all embryos were frozen (group C1) and 1306 patients who had COH with fresh embryo transfer (ET) (group T1). Logistic regression was used to model the embryo implantation and clinical pregnancy rates based on the mother's age, numbers of oocytes retrieved, embryos transferred and high-quality embryos transferred. The embryo implantation and clinical pregnancy rates were also compared between two groups after adjusting for age, the numbers of oocytes retrieved and the numbers of embryos transferred.

RESULTS

Logistic regression analysis confirmed that embryo implantation and clinical pregnancy rates in group C1 were both significantly higher than those in group T1 after adjusting for confounding factors (43.6% vs 29.0%, 63.1% vs 47.0%, respectively; P < 0.01). The embryo implantation and clinical pregnancy rates were consistently higher in group C1 by comparing the age groups >or= 35 or < 35 years. The clinical pregnancy rates for the numbers of oocytes retrieved per cycle being >or= 15 or < 15 were higher in group C1, as was the embryo implantation rate. These differences were statistically significant for oocyte numbers >or= 15 (P < 0.05). The embryo implantation and clinical pregnancy rates in group C1 were both significantly higher than in group T1 when two or three embryos were transferred (P < 0.05).

CONCLUSION

A program of freezing all embryos and performing FET improved the rates of embryo implantation and clinical pregnancy, and ultimately enhanced the embryo utilization rate.

摘要

背景

冻融胚胎移植（FET）是预防严重晚期卵巢过度刺激综合征和提高累积妊娠率的最常见方法。我们评估了 FET 方案在改善不孕治疗中胚胎着床和临床妊娠率以及最终胚胎利用率方面的有效性。

方法

纳入 2006 年 1 月至 2008 年 6 月接受体外受精（IVF）周期的患者，包括 179 例接受控制性卵巢刺激（COH）后首次 FET 周期的患者，所有胚胎均冷冻（C1 组），和 1306 例接受 COH 伴新鲜胚胎移植（ET）的患者（T1 组）。基于母亲年龄、获卵数、移植胚胎数和优质胚胎数，采用 logistic 回归模型分析胚胎着床和临床妊娠率。在调整年龄、获卵数和移植胚胎数后，比较两组间的胚胎着床和临床妊娠率。

结果

logistic 回归分析证实，调整混杂因素后，C1 组胚胎着床和临床妊娠率均显著高于 T1 组（分别为 43.6%比 29.0%，63.1%比 47.0%；P < 0.01）。>or=35 岁或<35 岁年龄组中，C1 组胚胎着床和临床妊娠率均较高。在每个周期获卵数>or=15 或<15 时，C1 组的临床妊娠率更高，胚胎着床率也更高。对于获卵数>or=15，这些差异具有统计学意义（P < 0.05）。当移植 2 或 3 个胚胎时，C1 组胚胎着床和临床妊娠率均显著高于 T1 组（P < 0.05）。