摘要
目的探讨1次移植2枚胚胎时发生双胎妊娠的风险因素。方法回顾性分析2970例1次移植2个胚胎移植周期资料，其中新鲜胚胎移植周期1984例、冻融胚胎移植周期986例，应用多因素Logistic回归法分析发生双胎妊娠的风险因素，并比较年龄〈35岁和≥35岁，移植0、1、2个优质胚胎以及不同移植时机的移植周期双胎妊娠率。结果（1）多因素Logistic回归分析发现女方年龄与双胎妊娠呈负相关（P〈0．01）、移植优质胚胎个数和冻融胚胎移植与双胎妊娠正相关（均P〈0．01）；（2）新鲜胚胎移植周期和冻融胚胎移植周期的双胎妊娠率在女方年龄〈35岁组均显著高于≥35岁组（16．0％比8．0％，P〈0．01；26．9％比14．2％，P〈0．01）；（3）新鲜胚胎移植周期移植2个优质胚胎的双胎妊娠率显著高于移植0个和1个优质胚胎组（19．1％比5．4％和11．0％，均P〈0．01）；冻融胚胎移植周期移植2个优质胚胎的双胎妊娠率亦显著高于移植0个和1个优质胚胎组（32．7％比10．8％和20．7％，均P〈0．01）；（4）冻融胚胎移植周期双胎妊娠率显著高于新鲜胚胎移植周期（24．7％比14．9％，P〈0．01）。结论女方年龄、移植优质胚胎个数和冻融胚胎移植是双胎妊娠发生的高危因素；在冻融胚胎移植技术成熟的中心，对于女方年轻的患者，在FET周期建议单优胚移植。
Objective To explore the risk factors associated with twin pregnancy in double embryo transfer. Methods A retrospective analysis was performed for 2970 double embryo transfer cycles, including 1984 cycles of fresh embryo transfer and 986 cycles of frozen-thawed embryo transfer （FET）. Multiple factor Logistic regression was used. The twin pregnancy rate was studied in group of age 〈 35 or age ≥35 years old, in group of zero, single or double high-quality embryos transferred and group of fresh embryo transfer or FET cycles. Results （1） There was a significantly negative correlation between women＇s age and twin pregnancy according to the analysis of multiple factor Logistic regression （ P 〈 0. 01 ）. And a significantly positive correlation existed between the number of high-quality embryos transferred, FET and twin pregnancy （P 〈0. 01 ） ; （2）the twin pregnancy rate of both fresh embryo transfer and FET cycles was higher in group of age 〈35 years than that in group of age ≥35 years （16.0% vs8.0%, P〈0.01; 26.9% vs 14. 2%, P 〈0. 01 ）; （3）the twin pregnancy rate of fresh embryo transfer cycles with double high-quality embryos transferred was higher than that with zero or single high-quality embryos transferred （ 19. 1% vs 5.4% ; 19. 1% vs 11. 0% , P 〈 0. 01 ） ; the twin pregnancy rate of FET cycles with double high-quality embryos transferred was also higher than that with zero or single high-quality embryos transferred （32. 7% vs 10. 8% ; 32. 7% vs 20. 7% , P 〈 0. 01 ） ; （4） the twin pregnancy rate of FET cycles was significantly higher than that of fresh embryo transfer cycles （24. 7% vs 14. 9%, P 〈 0. 01 ）. Condusion Women＇s age, the number of high quality embryos transferred and FET are risk factors associated with twin pregnancy. At reproductive centers with a mature technique of FET, we recommend performing single high-quality embryo transfer in FET cycles to reduce the occurrence of twin pregnancy.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第37期2615-2618,共4页
National Medical Journal of China
基金
基金项目：浙江省科技厅公益研究社会发展项目（2010C33032）
关键词
胚胎移植
年龄
胚胎
双胎
冻融胚胎移植
Embryo transfer
Age
High-quality embryo
Twins
Frozen-thawed embryo transfer
