摘要
目的:探讨导致冷冻胚胎移植失败的高危因素。方法:对2009年5月至2012年5月在长治医学院附属和平医院生殖中心接受冷冻胚胎移植的328例患者的相关资料进行回顾性分析。根据患者是否成功临床妊娠分为妊娠组(107例)和未妊娠组(221例)。对年龄、不孕时间、不孕原因、冻融方法、胚胎发育时间、胚胎等级、子宫内膜准备方法、子宫内膜厚度、激素水平(雌激素/孕激素,E2/P)、受精方式、移植位置(移植胚胎到宫底的距离/宫颈内口到宫底的距离,DA/DB)11个因素进行分析,用logistic回归模型筛选冷冻胚胎移植失败的高危因素。结果:妊娠组与未妊娠组的年龄(t=3.908,P<0.001)、冻融方法(χ2=10.239,P<0.001)、胚胎等级(χ2=9.853,P=0.002)、子宫内膜厚度(χ2=77.556,P<0.001)、激素水平(χ2=39.265,P<0.001)、移植位置(χ2=12.395,P=0.002)比较,差异有统计学意义。Logistic回归分析结果显示年龄(P=0.026)、冻融方法(P=0.005)、胚胎等级(P<0.001)、子宫内膜厚度(P=0.026)与妊娠结局有关,其OR值(95%CI)分别为0.537(0.310～0.929)、0.472(0.279～0.798)、0.221(0.108～0.455)和0.654(0.451～0.950)。结论:高龄、胚胎质量不佳、子宫内膜容受性差是导致冷冻胚胎移植失败的独立高危因素。
Aim ： To explore the high risk factors in frozen embryo transplantation failure. Methods： The related data of 328 patients who accepted frozen embryo transplantation were retrospectively analyzed. Patients were divided into preg- nancy group （ n = 107 ） and non-pregnancy group （ n = 221 ）. Age, duration of infertility, causes of infertility, frozen meth-od, embryonic development time, embryo grade, endometrial preparation method, endometrial thickness, hormone level （estrogen/progesterone, E2/P） , insemination way, and transplantation position （DA/DB） were analyzed. The high risk factors were Screened using logistic regression model. ResultS： The differences of age （t = 3. 908, P 〈 0. 001 ） , frozen method（x2 = 10. 239, P 〈 0. 001） , embryo grade（x2 = 9. 853, P = 0. 002） , endometrial thickness （x2 = 77. 556, P 〈 0. 001 ） , hormone level（x2 = 39. 265, P 〈 0. 001 ） and transplantation position （X2 = 12. 395, P = 0. 002） between preg- nancy group and non-pregnancy group were significant. Logistic regression analysis results displayed that age（P = 0. 026） , frozen method （ P = 0. 005 ） , embryo grade （ P 〈 0.001 ） , endometrial thickness （ P = 0. 026 ） were related to pregnancy out- come, and 0R（95% C1） were 0.537（0.310 -0.929）,0.472（0.279 -0.798）,0.221（0. 108 -0.455） and 0.654 （0. 451 -0. 950）. Conclusion： Advanced age, poor embryo quality and bad endometrial receptivity are the independent high risk factors which lead to the failure of frozen embryo transplantation.
出处
《郑州大学学报（医学版）》
CAS
北大核心
2013年第3期403-406,共4页
Journal of Zhengzhou University(Medical Sciences)
