Center for Reproductive Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2023 Feb 25;52(1):24-32. doi: 10.3724/zdxbyxb-2022-0510.
To compare perinatal outcomes and the incidence of pregnancy complications between fresh embryo transfer and frozen embryo transfer in singleton pregnant women.
The clinical data of 3161 fertilization-embryo transfer cycles conducted in Center for Reproductive Medicine of the Third Affiliated Hospital of Sun Yat-sen University from October 2015 to May 2021 were retrospectively analyzed, among which 1009 cases were fresh embryo transfer (fresh embryo group) and 2152 cases were frozen embryo transfer (frozen embryo group). The baseline characteristics were compared between two groups, and logistic regression was used to analyze the effect of fresh embryo transfer and frozen embryo transfer on pregnancy outcome and complications.
Compared with the fresh embryo group, the frozen embryo group had an increased gestational age (<0.01), increased birth weight (<0.01), higher cesarean section rate (65.1% 50.7%, =1.791, 95%: 1.421-2.256, <0.01), higher risk of large for gestational age infant (12.7% 9.4%, =1.487, 95%: 1.072-2.064, <0.05) and macrosomia (5.4% 3.2%, =2.126, 95%: 1.262-3.582, <0.01). The incidences of early abortion (18.5% 16.2%, =1.377, 95%: 1.099-1.725, <0.01) and gestational hypertension (3.1% 1.9%, =1.862, 95%: 1.055-3.285, <0.05) in the frozen embryo group were significantly higher than those in the fresh embryo group. Stratified analyses by stage of embryo transfer showed that during blastocyst transfer, the gestational weeks of delivery, birth weight and risk of cesarean section in frozen embryo group were significantly higher than those in fresh embryo group. During cleavage stage embryo transfer, frozen embryo transfer was associated with a higher risk of cesarean section, macrosomia, miscarriage and early miscarriage, and the birth weight of newborns was also significantly increased.
Compared with fresh embryo transfer, frozen embryo transfer is associated with a higher risk of abortion, early abortion, large for gestational age infant, macrosomia, cesarean section, and pregnancy induced hypertension. The birth weight of newborns after frozen embryo transfer is also significantly increased.
比较新鲜胚胎移植和冷冻胚胎移植在单胎妊娠妇女中的围产期结局和妊娠并发症发生率。
回顾性分析中山大学附属第三医院生殖医学中心 2015 年 10 月至 2021 年 5 月进行的 3161 个体外受精-胚胎移植周期的临床资料，其中 1009 例为新鲜胚胎移植（新鲜胚胎组），2152 例为冷冻胚胎移植（冷冻胚胎组）。比较两组的基本情况，采用 logistic 回归分析新鲜胚胎移植和冷冻胚胎移植对妊娠结局和并发症的影响。
与新鲜胚胎组相比，冷冻胚胎组的胎龄（<0.01）、出生体重（<0.01）、剖宫产率（65.1% vs. 50.7%，=1.791，95%：1.421-2.256，<0.01）、巨大儿发生率（12.7% vs. 9.4%，=1.487，95%：1.072-2.064，<0.05）和巨大儿发生率（5.4% vs. 3.2%，=2.126，95%：1.262-3.582，<0.01）更高。冷冻胚胎组早期流产（18.5% vs. 16.2%，=1.377，95%：1.099-1.725，<0.01）和妊娠期高血压（3.1% vs. 1.9%，=1.862，95%：1.055-3.285，<0.05）的发生率明显高于新鲜胚胎组。按胚胎移植阶段分层分析显示，在囊胚移植时，冷冻胚胎组的分娩孕周、出生体重和剖宫产率明显高于新鲜胚胎组。在卵裂期胚胎移植时，冷冻胚胎移植与剖宫产、巨大儿、流产及早产的风险增加相关，新生儿出生体重也明显增加。
与新鲜胚胎移植相比，冷冻胚胎移植与流产、早期流产、巨大儿、巨大儿、剖宫产和妊娠高血压的风险增加有关。冷冻胚胎移植后新生儿的出生体重也显著增加。
