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第5天或第6天囊胚胚胎移植对接受体外受精的甲状腺功能正常女性妊娠结局的影响:一项单中心回顾性队列研究。

Effect of day 5 or 6 blastocyst embryo transfer on pregnancy outcomes in euthyroid women undergoing IVF: A single centre retrospective cohort.

作者信息

Negreiros Ricardo Andre Medeiros, d'Assunção Viviane Rosado Negreiros, d'Assunção Luis Eduardo Negreiros, Caldas Maria Madalena Pessoa, Sousa Eduardo Sérgio Soares

机构信息

Centre for Medical Sciences, Federal University of Paraíba, Paraíba, Brazil.

University Center of João Pessoa (UNIPE), Paraíba, Brazil.

出版信息

JBRA Assist Reprod. 2024 Dec 3;28(4):535-542. doi: 10.5935/1518-0557.20240036.

Abstract

OBJECTIVE

This study examined whether blastocysts transferred on day 5 or day 6 of embryo development, as well as positivity for anti-thyroid peroxidase antibodies, affect gestational outcomes in euthyroid women undergoing in vitro fertilisation.

METHODS

Of 428 women who underwent in vitro fertilisation assessed in this retrospective cohort study, 212 (49.5%) underwent embryo transfer on day 5 of blastulation and 216 (50.5%) on day 6. Dichotomization based on anti-thyroid peroxidase antibodies status was also performed, with 370 (86.4%) women testing negative and 58 (13.6%) testing positive. Clinical and hormonal data and rates of clinical pregnancy, miscarriage, and live births were compared between the groups.

RESULTS

When evaluating gestational outcomes based on the day of blastulation, a statistically significant difference was observed in clinical pregnancy rates [51.4% (day 5) vs. 40.7% (day 6); p=0.033]. However, there was no significant difference in the relative frequencies of miscarriages (p=1.000), live births (p=1.000), or preterm births (p=1.000). Using Cramer's V test, a weak association was found between the day of blastulation and clinical pregnancy outcomes (V2=10.7%; p=0.027). There were no statistically significant differences between the anti-thyroid peroxidase antibodies-negative and -positive groups in terms of clinical pregnancy rates (p=0.396), miscarriages (p=0.129), and live births (p=0.129).

CONCLUSIONS

Higher rates of clinical pregnancy were observed in women who underwent embryo transfers performed on day 5 compared to those on day 6. However, no effect was observed with gestational outcomes. Further, anti-thyroid peroxidase antibody positivity did not have a statistically significant impact on gestational outcomes.

摘要

目的

本研究探讨在胚胎发育第5天或第6天移植的囊胚,以及抗甲状腺过氧化物酶抗体阳性,是否会影响接受体外受精的甲状腺功能正常女性的妊娠结局。

方法

在这项回顾性队列研究中,对428名接受体外受精的女性进行评估,其中212名(49.5%)在囊胚形成第5天进行胚胎移植,216名(50.5%)在第6天进行移植。还根据抗甲状腺过氧化物酶抗体状态进行二分法分析,370名(86.4%)女性检测为阴性,58名(13.6%)检测为阳性。比较两组之间的临床和激素数据以及临床妊娠、流产和活产率。

结果

根据囊胚形成日期评估妊娠结局时,临床妊娠率存在统计学显著差异[51.4%(第5天)对40.7%(第6天);p = 0.033]。然而,流产(p = 1.000)、活产(p = 1.000)或早产(p = 1.000)的相对频率没有显著差异。使用克莱默V检验,发现囊胚形成日期与临床妊娠结局之间存在弱关联(V2 = 10.7%;p = 0.027)。抗甲状腺过氧化物酶抗体阴性和阳性组在临床妊娠率(p = 0.396)、流产(p = 0.129)和活产(p = 0.129)方面没有统计学显著差异。

结论

与第6天进行胚胎移植的女性相比,第5天进行胚胎移植的女性临床妊娠率更高。然而,未观察到对妊娠结局有影响。此外,抗甲状腺过氧化物酶抗体阳性对妊娠结局没有统计学显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a65f/11622402/271c0081a3c9/jbra-28-04-0535-g01.jpg

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