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腹腔镜输卵管结扎术与冻融胚胎移植之间的时间间隔不会影响生殖结局。

The time interval between laparoscopic tubal ligation and frozen-thawed embryo transfer does not affect the reproductive outcomes.

机构信息

Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, People's Republic of China.

Department of Reproductive Gynecology, Northwest Women's and Children's Hospital, No. 73, Houzaimen Street, Xi'an, People's Republic of China.

出版信息

BMC Pregnancy Childbirth. 2023 Aug 3;23(1):564. doi: 10.1186/s12884-023-05880-3.

Abstract

BACKGROUND

Hydrosalpinx may decrease implantation and pregnancy rates after embryo transfer. Laparoscopic tubal ligation after embryo freeze and before frozen-thawed embryo transfer (FET) is effective at improving reproductive outcomes for hydrosalpinx patients. This study is to find out the optimal interval between laparoscopic tubal ligation and FET.

METHODS

We retrospectively analyzed 259 infertile women who performed laparoscopic tubal ligation for embryo freeze and FET. Participants were divided into three groups, based on the interval between laparoscopic tubal ligation and FET. Group I: <30 days; Group II: 31- 60 days; Group III: >60 days. Outcomes of cleavage-stage and blastocyst-stage embryo FET were analyzed respectively.

RESULTS

There was no significant difference in clinical pregnancy rate, live birth rate, implantation rate, biochemical pregnancy rate, ectopic pregnancy rate, miscarriage rate and preterm birth rate among the three groups, in both cleavage-stage and blastocyst-stage embryo FET cycles. In cleavage-stage embryo FET cycle, singleton gestational age was significantly younger in group III (38.11 ± 2.28 weeks) compared with group I (39.29 ± 1.06 weeks, P = 0.001) and group II (38.96 ± 1.05, P = 0.026). Singleton birth weight was significantly heavier in group II (3.65 ± 0.32 Kg) compared with group I (3.38 ± 0.29 Kg, P = 0.001) and group III (3.35 ± 0.60 Kg, P = 0.004). Twin birth weight was significantly heavier in group III (2.72 ± 0.43 Kg) compared to group I (2.23 ± 0.67 Kg, P = 0.002). In blastocyst-stage embryo FET cycles, twin gestational age was significantly younger in group II (34.07 ± 3.18 weeks) compared with group I (35.56 ± 2.27 weeks, P = 0.049) and group III (36.50 ± 1.47 weeks, P = 0.005). Twin birth weight was significantly heavier in group III (2.71 ± 0.39 Kg) compared to group II (2.39 ± 0.67 Kg, P = 0.009).

CONCLUSIONS

The duration of the interval between laparoscopic tubal ligation and FET does not affect the reproductive outcomes; however, it may affect the neonate outcomes to some extent.

摘要

背景

输卵管积水可降低胚胎移植后的种植率和妊娠率。胚胎冷冻后行腹腔镜输卵管结扎术,然后进行冻融胚胎移植(FET),可有效改善输卵管积水患者的生殖结局。本研究旨在探讨腹腔镜输卵管结扎术与 FET 之间的最佳间隔时间。

方法

我们回顾性分析了 259 名因胚胎冷冻和 FET 而行腹腔镜输卵管结扎术的不孕妇女。根据腹腔镜输卵管结扎术与 FET 之间的间隔时间,将患者分为三组。I 组:<30 天;II 组:31-60 天;III 组:>60 天。分别分析卵裂期和囊胚期胚胎 FET 的结局。

结果

三组卵裂期和囊胚期胚胎 FET 周期的临床妊娠率、活产率、种植率、生化妊娠率、异位妊娠率、流产率和早产率均无统计学差异。在卵裂期胚胎 FET 周期中,III 组(38.11±2.28 周)的单胎妊娠年龄明显小于 I 组(39.29±1.06 周,P=0.001)和 II 组(38.96±1.05 周,P=0.026)。II 组(3.65±0.32kg)的单胎出生体重明显重于 I 组(3.38±0.29kg,P=0.001)和 III 组(3.35±0.60kg,P=0.004)。III 组(2.72±0.43kg)的双胎出生体重明显重于 I 组(2.23±0.67kg,P=0.002)。在囊胚期胚胎 FET 周期中,II 组(34.07±3.18 周)的双胎妊娠年龄明显小于 I 组(35.56±2.27 周,P=0.049)和 III 组(36.50±1.47 周,P=0.005)。III 组(2.71±0.39kg)的双胎出生体重明显重于 II 组(2.39±0.67kg,P=0.009)。

结论

腹腔镜输卵管结扎术与 FET 之间的间隔时间长短并不影响生殖结局,但可能在一定程度上影响新生儿结局。

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本文引用的文献

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Hydrosalpinx - Salpingostomy, salpingectomy or tubal occlusion.积水输卵管 - 输卵管造口术、输卵管切除术或输卵管阻塞。
Best Pract Res Clin Obstet Gynaecol. 2019 Aug;59:41-47. doi: 10.1016/j.bpobgyn.2019.01.011. Epub 2019 Jan 29.
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Transferring two grades I cleavage-stage embryo might not be a good protocol.移植两个I级卵裂期胚胎可能不是一个好方案。
Gynecol Endocrinol. 2017 Jul;33(7):557-559. doi: 10.1080/09513590.2017.1302420. Epub 2017 Mar 28.

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