Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, 100191, China.
National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, 100191, China.
BMC Pregnancy Childbirth. 2023 Feb 3;23(1):92. doi: 10.1186/s12884-023-05418-7.
There is ongoing debate regarding which embryo transfer procedure can achieve a higher live birth rate. Research has suggested that frozen ET might be beneficial for certain populations, such as hyper-responders. This study aimed to compare outcomes of pregnancies between frozen and fresh embryo transfer cycles in patients with endometrial hyperplasia and carcinoma.
This retrospective cohort study was conducted at a high-volume reproductive center from January 2010 to January 2022. Patients who were diagnosed with endometrial hyperplasia with atypia and endometrial carcinoma were included. They all underwent in vitro fertilization after conservative treatment. The primary outcome was live birth after frozen and fresh embryo transfer cycles, and secondary outcomes included perinatal complications and other pregnancy outcomes.
Overall, 259 ET cycles (130 fresh and 129 frozen) were included. The rate of live births per embryo transfer cycle of the whole cohort was 20.8% (54/259), and no significant between-group difference was found after adjusting for potential confounding factors (23.8% vs. 17.8%; adjusted OR, 0.47; 95% CI, 0.21-1.06; p=0.068). Compared to fresh embryo transfer group, the incidence of total maternal complications in the frozen embryo transfer group was significantly higher (30.4% vs. 6.5%, p=0.019). Analyzing each complication as a separate entity, patients in the frozen embryo transfer group had a higher incidence of hypertensive disorders of pregnancy (p=0.028). Multiple logistic regression analysis showed that frozen embryo transfer was related with an increased occurrence of maternal complications (OR, 6.68, 95% CI, 1.01-44.19, p=0.040).
Among patients with endometrial hyperplasia and carcinoma, the rate of live births was comparable between both embryo transfer procedures, while frozen embryo transfer might be associated with a higher risk of maternal complications compared to that with fresh embryo transfer.
目前对于哪种胚胎移植程序可以提高活产率仍存在争议。有研究表明，冷冻胚胎移植可能对某些人群有益，如超敏反应者。本研究旨在比较子宫内膜增生和癌患者的冷冻胚胎移植周期与新鲜胚胎移植周期的妊娠结局。
这是一项回顾性队列研究，于 2010 年 1 月至 2022 年 1 月在一家高容量生殖中心进行。纳入经保守治疗后接受体外受精的子宫内膜增生伴不典型和子宫内膜癌患者。主要结局是冷冻和新鲜胚胎移植周期后的活产率，次要结局包括围产期并发症和其他妊娠结局。
共纳入 259 个胚胎移植周期（130 个新鲜胚胎移植周期和 129 个冷冻胚胎移植周期）。整个队列中每个胚胎移植周期的活产率为 20.8%（54/259），调整潜在混杂因素后两组间无显著差异（23.8%比 17.8%；调整后 OR，0.47；95%CI，0.21-1.06；p=0.068）。与新鲜胚胎移植组相比，冷冻胚胎移植组的总产妇并发症发生率明显更高（30.4%比 6.5%，p=0.019）。分析每个并发症作为单独实体，冷冻胚胎移植组妊娠高血压疾病的发生率更高（p=0.028）。多因素逻辑回归分析显示，冷冻胚胎移植与产妇并发症的发生增加相关（OR，6.68，95%CI，1.01-44.19，p=0.040）。
在子宫内膜增生和癌患者中，两种胚胎移植程序的活产率相当，而与新鲜胚胎移植相比，冷冻胚胎移植可能与产妇并发症风险增加相关。
