摘要
目的探讨子宫内膜厚度对冻融卵裂期和囊胚期胚胎移植妊娠安全性和活产率的影响,为临床实践提供指导。方法回顾性分析2014年1月~2015年12月在我院生殖门诊接受冻融胚胎移植的4679个周期的临床资料,根据子宫内膜厚度将其分为A组(子宫内膜厚度<7 mm,743个周期)与B组(子宫内膜厚度≥7 mm,3936个周期)。按照移植胚胎类型将A组分为D3A组和D5A组,B组分为D3B组和D5B组。D3A组:子宫内膜厚度<7 mm,移植卵裂期胚胎,41个周期;D5A组:内膜厚度<7 mm,移植囊胚,702个周期;D3B组:内膜厚度≥7 mm,移植卵裂期胚胎,246个周期;D5B组:内膜厚度≥7 mm,移植囊胚,3690个周期。比较各组的移植胚胎数、临床妊娠率、种植率、流产率、异位妊娠率、活产率、早产率、低出生体重儿发生率、巨大儿发生率及围生儿死亡率。结果A组的种植率、临床妊娠率、活产率均低于B组,流产率、低出生体重儿发生率、巨大儿发生率、围生儿死亡率均高于B组,差异有统计学意义(P<0.05)。D3A组的临床妊娠率和活产率均低于D3B组,早产率和围生儿死亡率均高于D3B组,差异有统计学意义(P<0.05)。D5A组的种植率、临床妊娠率和活产率均低于D5B组,流产率、低出生体重儿发生率、巨大儿发生率、围生儿死亡率均高于D5B组,差异有统计学意义(P<0.05)。D3A组的种植率、临床妊娠率和活产率均低于D5A组,移植胚胎数、流产率、早产率、围生儿死亡率均高于D5A组,差异有统计学意义(P<0.05)。结论冻胚移植周期中,囊胚移植的结局更佳。薄型子宫内膜(<7 mm)患者移植后妊娠率、种植率和活产率低,同时孕产期和围生儿并发症高,但该类患者可以选择囊胚移植以提高种植率、临床妊娠率、活产率。
Objective To explore the effect of endometrial thickness on pregnancy safety and live birth rate of embryo transfer during freeze-thaw cleavage and blastocyst stage,so as to provide guidance for clinical practice.Methods The clinical data of 4679 cycles received frozen-thaw embryo transfer in reproductive clinic of our hospital from January 2014 to December 2015 were retrospectively analyzed.They were divided into group A(endometrial thickness<7 mm,743 cycles)and group B(endometrial thickness≥7 mm,3936 cycles)based on endometrial thickness.According to the types of embryo transfer,the group A was divided into D3A group and D5A group,and the group B was divided into D3B group and D5B group.D3A group:endometrial thickness<7 mm,cleavage stage embryos transfer,41 cycles;D5A group:endometrial thickness<7 mm,blastocyst transfer,702 cycles;D3B group:endometrial thickness≥7 mm,cleavage stage embryos transfer,246 cycles;D5B group:endometrial thickness≥7 mm,blastocysts transfer,3690 cycles.The number of transferred embryos,clinical pregnancy rate,implantation rate,miscarriage rate,ectopic pregnancy rate,live birth rate,preterm birth rate,incidence of low birth weight infants,incidence of gigantic infants and perinatal mortality were compared in each group.Results The implantation rate,clinical pregnancy rate,and live birth rate of group A were lower than those of group B,the miscarriage rate,the incidence of low birth weight infants,the incidence of gigantic infants,and the perinatal mortality were higher than those of group B,and the differences were statistically significant(P<0.05).The clinical pregnancy rate and live birth rate of the D3A group were lower than those of the D3B group,the preterm birth rate and perinatal mortality were higher than those of the D3B group,and the differences were statistically significant(P<0.05).The implantation rate,clinical pregnancy rate,and live birth rate in the D5A group were lower than those in the D5B group,the miscarriage rate,the incidence of low birth weight infants,the incidence of gigantic infants,and the perinatal mortality were higher than those in the D5B group,and the differences were statistically significant(P<0.05).The implantation rate,clinical pregnancy rate,and live birth rate in the D3A group were lower than those in the D5A group,the number of transferred embryos,abortion rate,preterm birth rate,and perinatal mortality were higher than those in the D5A group,and the differences were statistically significant(P<0.05).Conclusion The pregnancy outcomes of blastocyst transfer are better during frozen-embryo.The rate of pregnancy,implantation rate and live birth rate of thin endometrium transfer are low,while the complications are higher during pregnancy and perinatal period.For patients with thin endometrium(<7 mm),blastocyst transfer can be selected to increase the implantation rate,clinical pregnancy rate and live birth rate.
作者
刘玲
周娜
王欢
杨娜
黄越
许娇
杨逸尘
任海琴
LIU Ling;ZHOU Na;WANG Huan;YANG Na;HUANG YueXU Jiao;YANG Yi-chen;REN Hai-qin(Shenyang Oriental Jinghua Hospital Co.,Ltd.,Liaoning Province,Shenyang110005,China)
出处
《中国当代医药》
2019年第36期133-136,148,共5页
China Modern Medicine
基金
辽宁省沈阳市卫计委青年科研课题（2018118）
关键词
卵裂期胚胎移植
囊胚期胚胎移植
妊娠结局
活产率
Cleavage embryo transfer
Blastocyst embryo transfer
Pregnancy outcome
Live birth rate
