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新鲜胚胎与冻存第2天胚胎移植的辅助生殖技术结局:一项回顾性配对队列研究

Assisted reproduction technique outcomes for fresh versus deferred cryopreserved day-2 embryo transfer: a retrospective matched cohort study.

作者信息

Bourdon Mathilde, Santulli Pietro, Gayet Vanessa, Maignien Chloé, Marcellin Louis, Pocate-Cheriet Khaled, Chapron Charles

机构信息

Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France.

Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France; Institut Cochin, INSERM U1016, Laboratoire d'immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.

出版信息

Reprod Biomed Online. 2017 Mar;34(3):248-257. doi: 10.1016/j.rbmo.2016.11.015. Epub 2016 Dec 19.

Abstract

Ovarian stimulation could adversely affect endometrial receptivity and consequently embryo implantation. One emerging strategy is the 'freeze-all' approach. Most studies have focused on blastocyst transfers, with limited research on day-2 deferred cryopreserved embryo transfers. In this large retrospective cohort study, outcomes were compared between day-2 fresh versus deferred cryopreserved embryo transfers. After matching by age and number of previous cycles, 325 cycles were included in the fresh group and 325 in the deferred cryopreserved embryo transfers group: no significant differences were found between groups in implantation (0.20 ± 0.33 versus 0.17 ± 0.31, respectively) and ongoing pregnancy rates (21.85% versus 18.46%). Independent predictors for ongoing pregnancy after a multiple logistic regression analysis were the women's age (OR = 0.92; 95% CI 0.88 to 0.97), body mass index (OR = 0.94; 95% CI 0.89 to 0.99), the number of two pronuclei embryos (OR = 1.19; 95% CI 1.04 to 1.40) and at least one grade 1 embryo transferred (OR = 1.97; 95% CI 1.26 to 3.05). In the case of a day-2 embryo transfer, outcomes after treatment with assisted reproduction techniques are similar for fresh versus deferred cryopreserved embryo transfers when pre-transfer progesterone exposures are similar in the two groups.

摘要

卵巢刺激可能会对子宫内膜容受性产生不利影响,进而影响胚胎着床。一种新出现的策略是“全冷冻”方法。大多数研究都集中在囊胚移植上,对第2天延迟冷冻保存胚胎移植的研究有限。在这项大型回顾性队列研究中,比较了第2天新鲜胚胎移植与延迟冷冻保存胚胎移植的结局。在按年龄和既往周期数匹配后,新鲜胚胎移植组纳入325个周期,延迟冷冻保存胚胎移植组纳入325个周期:两组在着床率(分别为0.20±0.33和0.17±0.31)和持续妊娠率(21.85%和18.46%)方面均未发现显著差异。多元逻辑回归分析后,持续妊娠的独立预测因素为女性年龄(OR=0.92;95%CI 0.88至0.97)、体重指数(OR=0.94;95%CI 0.89至0.99)、双原核胚胎数量(OR=1.19;95%CI 1.04至1.40)以及至少移植一枚1级胚胎(OR=1.97;95%CI 1.26至3.05)。在进行第2天胚胎移植时,当两组移植前孕酮暴露相似时,新鲜胚胎移植与延迟冷冻保存胚胎移植在辅助生殖技术治疗后的结局相似。

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