Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Hospital, INF440, 69120, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University of Heidelberg, INF 130, 69120, Heidelberg, Germany.
Arch Gynecol Obstet. 2023 Jun;307(6):2001-2010. doi: 10.1007/s00404-023-07019-3. Epub 2023 Apr 16.
This study attempted at identifying the main parameters influencing the outcome of frozen embryo transfers.
This is a single-center retrospective cohort study of 830 frozen-embryo-transfer cycles performed at a German university hospital from January 2012 to December 2016. Main outcome parameters were the clinical pregnancy and live birth rate. Twelve patient- and cycle-dependent factors were analyzed in terms of their influence on the outcome of frozen embryo transfers. Multivariate logistic regression analysis was used for the modelling of the dependency of the different parameters on outcomes.
The clinical pregnancy rate in our study was 25.5%, the live birth rate was 16.1% with an average maternal age of 34.2 years at the time of the oocyte retrieval. In the univariate analysis age, number of transferred embryos, blastocyst versus cleavage stage transfer, embryo quality and mode of endometrial preparation affected the birth rate significantly. The birth rate after artificial endometrial preparation was significantly lower than the birth rate after transfers in modified natural cycles (12.8 versus 20.6% with p = 0.031). The multivariate logistic regression analysis showed a significant independent influence of age, number of transferred embryos, culture duration and mode of endometrial preparation on the frozen embryo transfer success rates. Body mass index, nicotine abuse, a history of PCO syndrome or endometriosis and the co-transfer of a second poor-quality embryo to a good-quality embryo appeared to be irrelevant for the outcome in our collective.
Age, number of transferred embryos, embryo culture duration and the mode of endometrial preparation are independent predictive factors of frozen embryo transfer outcomes.
本研究旨在确定影响冷冻胚胎移植结局的主要参数。
这是一项单中心回顾性队列研究，纳入了 2012 年 1 月至 2016 年 12 月在德国一家大学医院进行的 830 例冷冻胚胎移植周期。主要结局参数是临床妊娠率和活产率。分析了 12 个与患者和周期相关的因素，以评估其对冷冻胚胎移植结局的影响。采用多变量逻辑回归分析来评估不同参数对结局的依赖关系。
本研究的临床妊娠率为 25.5%，活产率为 16.1%，卵母细胞采集时的平均年龄为 34.2 岁。单因素分析显示，年龄、移植胚胎数量、囊胚与卵裂期胚胎移植、胚胎质量和子宫内膜准备方式均显著影响活产率。人工子宫内膜准备后的活产率明显低于改良自然周期后的活产率（12.8%比 20.6%，p=0.031）。多变量逻辑回归分析显示，年龄、移植胚胎数量、培养时间和子宫内膜准备方式对冷冻胚胎移植成功率有显著的独立影响。体质量指数、尼古丁滥用、多囊卵巢综合征或子宫内膜异位症病史以及将第二个质量差的胚胎与一个质量好的胚胎共同移植似乎与本研究群体的结局无关。
年龄、移植胚胎数量、胚胎培养时间和子宫内膜准备方式是冷冻胚胎移植结局的独立预测因素。
