Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
BMC Pregnancy Childbirth. 2023 Jan 4;23(1):5. doi: 10.1186/s12884-022-05315-5.
To explore the incidence of retained embryos (REs) in embryo transfer (ET) cycles and its effects on pregnancy outcomes in women undergoing in vitro fertilization (IVF).
This was a matched retrospective cohort study involving 29,160 ET cycles conducted from March 2016 to February 2021, in which ET cycles without RE were matched to the RE group at a 2:1 ratio. Clinical pregnancy, implantation, miscarriage, and live birth rates were compared between the with-RE and without-RE groups.
Our study showed that the overall incidence of REs was 0.33% (95/29,160). There was a statistically significant difference in RE rate among the operators (P < 0.001), suggesting that the embryo retention rate may be affected by the individual operator. A total of 95 repeated ET cycles due to RE were included in the study group, and 190 ET cycles without RE were matched to the study group (1:2). There were no significant differences between the RE and matched groups in terms of implantation rate (35.6 vs. 38.0%; P = 0.608), clinical pregnancy rate (47.4 vs. 54.7%; P = 0.240), biochemical pregnancy rate (5.3 vs. 4.7%; P = 0.846), miscarriage rate (11.1 vs. 9.6%; P = 0.781), ectopic pregnancy rate (2.2 vs. 1.9%; P = 1.000) or live birth rate (41.1 vs. 48.9%; P = 0.208).
The present findings demonstrated that immediate retransfer of REs did not significantly affect IVF outcomes, which may provide counselling information for patients when REs are identified and ET is reattempted. The incidence of REs was associated with the operator who expelled the embryos from the catheter. Attention to detail and frequent assessment of the operator's technique may facilitate avoidance of embryo retention.
探讨体外受精（IVF）中胚胎移植（ET）周期中胚胎滞留（RE）的发生率及其对妊娠结局的影响。
这是一项回顾性匹配队列研究，纳入了 2016 年 3 月至 2021 年 2 月期间进行的 29160 例 ET 周期，将无 RE 的 ET 周期与 RE 组以 2:1 的比例进行匹配。比较有 RE 组和无 RE 组的临床妊娠率、种植率、流产率和活产率。
本研究显示，RE 的总发生率为 0.33%（95/29160）。操作人员之间的 RE 发生率存在显著差异（P<0.001），提示胚胎滞留率可能受到操作人员个体的影响。共有 95 例因 RE 而重复进行的 ET 周期被纳入研究组，同时匹配了 190 例无 RE 的 ET 周期（1:2）。RE 组和匹配组在种植率（35.6%比 38.0%；P=0.608）、临床妊娠率（47.4%比 54.7%；P=0.240）、生化妊娠率（5.3%比 4.7%；P=0.846）、流产率（11.1%比 9.6%；P=0.781）、异位妊娠率（2.2%比 1.9%；P=1.000）和活产率（41.1%比 48.9%；P=0.208）方面均无显著差异。
本研究结果表明，立即重新转移 RE 对 IVF 结局无显著影响，这可为发现 RE 并尝试再次 ET 时患者提供咨询信息。RE 的发生率与将胚胎从导管中排出的操作人员有关。注重细节和频繁评估操作人员的技术可能有助于避免胚胎滞留。
