Laval Maude, Garlantézec Ronan, Guivarc'h-Levêque Anne
Reproductive Medicine, Groupe Hospitalier Bretagne Sud, 5 avenue Choiseul, 56322 Lorient, France.
University of Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), 9 Avenue du Professeur Léon Bernard, 35000 Rennes, France; Centre Hospitalier Universitaire de Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France.
J Gynecol Obstet Hum Reprod. 2020 Jan;49(1):101644. doi: 10.1016/j.jogoh.2019.101644. Epub 2019 Oct 5.
Perinatal risks after frozen embro transfer (FET) have been reassuring but some authors suggest that birthweights are higher after FET than after fresh embryo transfer (ET). The primary objective of this retrospective study, conducted in Clinique de la Sagesse, Rennes (France) from December 2013 to March 2017, was to determine whether a difference in birthweight exists between children conceived through in vitro fertilization (IVF) with frozen versus fresh ET. The secondary objective was to compare live birth rates after frozen versus fresh cycles.
All couples undergoing IVF were included. Cycles with gamete donation and twin pregnancies were excluded. Hormone therapy was used in all embryo transfers. The main outcome measures were the child's birthweight, mode of delivery, gestation length and sex, maternal characteristics, and IVF characteristics. The primary endpoint was birthweight.
We studied 5406 embryo transfers and the 708 resulting singleton live births on which birthweight data were available. Mean birthweight was 3357g after frozen embryo transfer versus 3183g after fresh embryo transfer (p<0.001). After adjusting for confounding factors, the children born after frozen embryo transfer were 165.2g heavier (95%CI [92.96-237.51]). No difference was found in gestation length. Live birth was obtained after the 1.6th IVF attempt. Live birth rate was higher for fresh cycles (19% versus 12%, p<0.001), and the caesarean rate lower (16% versus 21%).
Birthweight was higher after frozen embryo transfer for a similar gestational age. Further research is needed to elucidate the mechanisms responsible for this difference.
冷冻胚胎移植(FET)后的围产期风险一直令人放心,但一些作者认为FET后的出生体重高于新鲜胚胎移植(ET)后。这项回顾性研究于2013年12月至2017年3月在法国雷恩的智慧诊所进行,其主要目的是确定通过体外受精(IVF)使用冷冻胚胎与新鲜胚胎移植受孕的儿童在出生体重上是否存在差异。次要目的是比较冷冻周期与新鲜周期后的活产率。
纳入所有接受IVF的夫妇。排除配子捐赠周期和双胎妊娠。所有胚胎移植均使用激素疗法。主要观察指标为儿童的出生体重、分娩方式、妊娠时长和性别、母亲特征以及IVF特征。主要终点为出生体重。
我们研究了5406次胚胎移植以及708例有出生体重数据的单胎活产。冷冻胚胎移植后的平均出生体重为3357克,而新鲜胚胎移植后为3183克(p<0.001)。在调整混杂因素后,冷冻胚胎移植后出生的儿童重165.2克(95%CI[92.96 - 237.51])。妊娠时长未发现差异。在第1.6次IVF尝试后获得活产。新鲜周期的活产率更高(19%对12%,p<0.001),剖宫产率更低(16%对21%)。
在相似的孕周下,冷冻胚胎移植后的出生体重更高。需要进一步研究以阐明造成这种差异的机制。