Shapiro Bruce S, Daneshmand Said T, Garner Forest C, Aguirre Martha, Hudson Cynthia
Fertility Center of Las Vegas, Las Vegas, NV, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Nevada, Las Vegas, NV, USA.
Fertility Center of Las Vegas, Las Vegas, NV, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Nevada, Las Vegas, NV, USA.
Reprod Biomed Online. 2014 Sep;29(3):286-90. doi: 10.1016/j.rbmo.2014.04.009. Epub 2014 May 14.
Implantation failure has various causes, including impaired uterine receptivity following ovarian stimulation. This retrospective cohort study compared outcomes in patients with prior implantation failure who elected to undergo another fresh cycle versus those who opted for embryo cohort cryopreservation (freeze-all) and subsequent thaw. There were 269 patients with implantation failure following fresh autologous blastocyst transfer opting to undergo a subsequent cycle, with 163 choosing another fresh cycle and 106 electing freeze-all and subsequent thaw. Multiple logistic regression analysis indicated that cohort cryopreservation was associated with greater chance of live birth when compared with another fresh cycle (P < 0.0001). The odds ratio for live birth with freeze-all relative to a fresh cycle was 3.8 (95% CI 2.1-7.2). A second analysis was then performed using cumulative live birth rate as the outcome measure. Multiple logistic regression indicated freeze-all was associated with greater cumulative live birth rate than was a fresh cycle (OR 1.9, 95% CI 1.1-3.3, P = 0.0287). These findings suggest that, following implantation failure with fresh blastocysts, patients have a significantly greater chance of live birth with freeze-all and subsequent thaw than with another fresh cycle.
种植失败有多种原因，包括卵巢刺激后子宫容受性受损。这项回顾性队列研究比较了既往种植失败后选择再次进行新鲜周期移植的患者与选择胚胎队列冷冻保存（全冻）并随后解冻的患者的结局。有269例新鲜自体囊胚移植后种植失败的患者选择进行后续周期，其中163例选择再次进行新鲜周期移植，106例选择全冻并随后解冻。多因素logistic回归分析表明，与再次进行新鲜周期移植相比，队列冷冻保存与更高的活产几率相关（P < 0.0001）。全冻相对于新鲜周期的活产优势比为3.8（95%CI 2.1 - 7.2）。然后使用累积活产率作为结局指标进行了第二项分析。多因素logistic回归表明，全冻与比新鲜周期更高的累积活产率相关（优势比1.9，95%CI 1.1 - 3.3，P = 0.0287）。这些发现表明，新鲜囊胚种植失败后，患者进行全冻并随后解冻比再次进行新鲜周期移植有显著更高的活产几率。
