摘要
目的探讨供卵体外受精-胚胎移植(IVF-ET)冻融周期影响临床妊娠结局的因素.方法回顾性分析郑州大学第一附属医院生殖医学中心2009年4月至2018年12月431例供卵IVF-ET冻融周期的临床资料,比较临床妊娠组和非临床妊娠组的一般情况、临床各项指标、实验室各项指标及妊娠结局.采用Logistic回归分析可能影响临床妊娠结局的独立危险因素;采用接受者操作特性曲线(ROC)评估预测影响临床妊娠结局的危险因素对供卵周期临床妊娠结局的预测作用.结果(1)临床妊娠组女方年龄小于非临床妊娠组,基础卵泡刺激素(FSH)值高于非临床妊娠组,形成可移植胚胎数、优质胚胎数及移植胚胎数多于非临床妊娠组,差异有统计学意义(P<0.05);早发性卵巢功能不全(POI)患者临床妊娠率(75.00%)显著高于高龄卵巢功能衰退(55.83%,P=0.005)及染色体异常组(56.86%,P=0.021);(2)Logistic回归分析提示,POI(OR=2.065,95%CI=1.026~4.156)、基础FSH值(0R=1.499,95%CI=1.072~1.959)、优质胚胎数(OR=1.449,95%CI=1.072~1.959)、移植胚胎数(OR=2.583,95%CI=1.519~4.391)是临床妊娠率的独立影响因素(P<0.05);(3)对基础FSH值绘制ROC曲线,曲线下面积为0.627,95%CI=0.572~0.680,临床截断值为19.28U/L.根据年龄及基础FSH值,进一步分为4组,结果提示,年龄≤40岁、FSH>19U/L组的临床妊娠率显著高于其他3组,差异有统计学意义(P<0.05).移植2枚胚胎的患者临床妊娠率及多胎妊娠率均高于移植1枚胚胎(P<0.01).结论POI患者受卯临床妊娠率高于其他不孕原因受卵患者.受卵患者移植2枚胚胎临床妊娠率显著高于移植1枚胚胎,但其多胎妊娠率亦显著增加.
Objective To determine independent factors of pregnancy in the recipient after frozen-thawed embryo transfer(FTET).Methods We performed a retrospective study of 431 patients who had undergone embryo transfer after oocyte donation(OD),in vitro fertilization and embryo cryopreservation between April 2009 and December 2018 at our Reproductive Center.Comparison of general data between clinical pregnant group and non-pregnant group;Logistic regression were used to identify independent factors of pregnancy.The ability of independent factors of pregnancy was assessed by receiver operating characteristics(ROC).Results①Pregnancy rates were significantly higher in women with more embryos,more high-quality embryos,more transferred embryos and higher basalfollicular stimulation hormone(FSH)(P<0.05).Pregnancy rate of premature ovarian insufficiency(POI)(75.00%)was higher than advanced age(55.83%,P=0.005)and chromosome abnormality(56.86%,P=0.021).②Using logistic regression analysis,the POI(OR=2.065,95%CI=1.026-4.156),basal FSH(OR=1.499,95%CI=1.072-1.959),high-quality embryos(OR=1.449,95%CI=1.072-1.959)and transferred embryos(OR=2.583,95%CI=1.519-4.391)were independent predictors of pregnancy(P<0.05).③The ROC curves revealed the cut-off points of basal FSH was 19.28U/L for pregnancy,the areas under the curve of basal FSH was 0.627,95%CI=0.572-0.680.According basal FSH and age,all patients were further divided into four groups,pregnancy rates were significantly higher in≤40 years and FSH>19U/L group(P<0.05).We contain pregnancy rates and multiple pregnancy rates of two transferred embryos were higher than one(P<0.01).Conclusions This study supports that pregnancy rates of POI was higher than other infertility diagnosis needed OD.Pregnancy rates of two transferred embryos were higher than one,but multiple pregnancy rates was also higher than one.
作者
张轶乐
王福珍
黄凯
金子琪
宋辉
谈雨
曾仪
Zhang Yile;Wang Fuzhen;Huang kai;Jin Ziqi;Song hui;Tan yu;Zeng yi(Reproductive Medical Center of the First Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2019年第44期3481-3486,共6页
National Medical Journal of China
关键词
供卵
冷冻胚胎移植
临床妊娠
Ocyte donation
Frozen embryo transfer
Pregnancy rate
