Shin Jieun, Kwon Hwang, Choi Dong Hee, Park Chan, Kim Ji Hyang, Kim Jeehyun, Kang Youn-Jung, Koo Hwa Seon
Department of Obstetrics and Gynecology, CHA Fertility Center Bundang, 59, Yatap-ro, Bundang-gu, Seongnam-si 13496, Gyeonggi-do, Korea.
Department of Biochemistry, Research Institute for Basic Medical Science, School of Medicine, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Korea.
J Clin Med. 2022 Aug 23;11(17):4940. doi: 10.3390/jcm11174940.
We aimed to assess the efficacy of accumulated embryo transfer (ACC-ET) through several controlled ovarian hyperstimulation (COS) cycles to increase the rates of pregnancy in patients with poor ovarian response (POR). We retrospectively reviewed the medical records of 588 patients with POR under 43-years old who underwent embryo transfer from January 2010 to December 2015. We compared the pregnancy rate (PR), clinical pregnancy rate (CPR), and live birth rate (LBR) between ACC-ET (frozen-thawed: 47; fresh + frozen-thawed: 24) group (n = 71) and fresh ET groups (n = 517). Characteristics of ACC-ET patients were similar to those of fresh ET groups (Age: 38.1 ± 3.5 vs. 38.2 ± 3.7, p = 0.88; Anti Müllerian Hormone (AMH; ng/mL): 0.5 ± 0.4 vs. 0.6 ± 0.6, p = 0.38; follicle stimulating hormone (FSH: mIU/mL): 11.9 ± 8.0 vs. 10.8 ± 9.0, p = 0.35). The total number of transferred embryos (3.1 ± 0.9 vs. 1.5 ± 0.7, p = 0.00), PR (29.6% (21/71) vs. 18.8% (97/517), p = 0.040), and CPR (23.5% (16/68) vs. 14.0% (71/508) p = 0.047) were significantly higher in the ACC-ET group than in the fresh ET group. In addition, PR, CPR, and LBR increased with the number of ET in the fresh ET group. However, there were no significant differences observed in LBR between ACC-ET and fresh ET groups (14.9% (10/67) vs. 9.8% (50/508), p = 0.203). From our knowledge, there is no clinical evidence reported to prove that transfer of multiple embryos of adequate quality obtained through multiple cycles can compensate for the limited number of retrieved oocytes from POR patients. We concluded that ACC-ET from several COS cycles could be an alternative method to increase PR and CPR in <43-year-old patients with POR.
我们旨在评估通过多个控制性卵巢刺激（COS）周期进行累积胚胎移植（ACC-ET），以提高卵巢反应不良（POR）患者的妊娠率。我们回顾性分析了2010年1月至2015年12月期间588例43岁以下接受胚胎移植的POR患者的病历。我们比较了ACC-ET组（冻融胚胎移植：47例；新鲜胚胎 + 冻融胚胎移植：24例）（n = 71）和新鲜胚胎移植组（n = 517）的妊娠率（PR）、临床妊娠率（CPR）和活产率（LBR）。ACC-ET组患者的特征与新鲜胚胎移植组相似（年龄：38.1±3.5岁 vs. 38.2±3.7岁，p = 0.88；抗苗勒管激素（AMH；ng/mL）：0.5±0.4 vs. 0.6±0.6，p = 0.38；促卵泡激素（FSH：mIU/mL）：11.9±8.0 vs. 10.8±9.0，p = 0.35）。ACC-ET组移植胚胎总数（3.1±0.9 vs. 1.5±0.7，p = 0.00）、PR（29.6%（21/71） vs. 18.8%（97/517），p = 0.040）和CPR（23.5%（16/68） vs. 14.0%（71/508），p = 0.047）显著高于新鲜胚胎移植组。此外，新鲜胚胎移植组的PR、CPR和LBR随胚胎移植次数增加而升高。然而，ACC-ET组和新鲜胚胎移植组的LBR无显著差异（14.9%（10/67） vs. 9.8%（50/508），p = 0.203）。据我们所知，尚无临床证据证明通过多个周期获得的多个质量合格的胚胎移植能够弥补POR患者回收的卵母细胞数量有限的问题。我们得出结论，对于<43岁的POR患者，通过多个COS周期进行ACC-ET可能是提高PR和CPR的一种替代方法。
