摘要
目的:探讨全胚冷冻后立即移植与延迟移植2种策略对冻融胚胎移植(frozen-thawed embryo transfer,FET)妊娠结局的影响。方法:回顾性分析2019年6月—2021年3月全胚冷冻后FET治疗患者的临床资料,按移植时机分为取卵后第1次月经来潮进行内膜准备(立即移植组,216例)和取卵后第2次月经来潮进行内膜准备(延迟移植组,1315例),按照样本量1∶2进行倾向性评分匹配,最终纳入研究的2组样本量分别为206例和377例。比较2组一般情况及妊娠结局。结果:2组一般情况比较差异无统计学意义(P>0.05),具有可比性。2组种植率、临床妊娠率、持续妊娠率和活产率比较差异无统计学意义(P>0.05),立即移植组早期流产率高于延迟移植组,差异有统计学意义(22.0%vs.11.5%,P=0.009)。二元Logistic回归校正混杂因素后,2组早期流产率比较差异有统计学意义(aOR=2.094,95%CI:1.138~3.852,P=0.018)。结论:全胚冷冻后立即FET患者的早期流产风险增加,但活产结局与延迟FET类似,该策略可以缩短到达妊娠时间,减少患者精神及心理压力。
Objective:To investigate the pregnancy outcome after immediate versus delayed frozen-thawed embryo transfer(FET)following a freeze-all in vitro fertilization and embryo transfer(IVF-ET)cycle.Methods:This was a retrospective clinical study conducting FET treatment between June 2019 and March 2021.Infertile women were assigned to either the immediate FET group in which FET was performed in the first menstrual cycle following the failed IVF cycle(n=216),or the delayed FET group in which FET was performed in the second menstrual cycle following the failed IVF cycle(n=1315).The propensity scoring matching(PSM)was used to control the confounding variables.The numbers of participants in the immediate and delayed FET groups after PSM were 206 and 377,respectively.This article compared the baseline characteristic and clinical outcomes within the two groups.Results:Basic parameters were not statistically different between the two groups(P>0.05).Patients in the immediate FET group had a comparable implantation rate,clinical pregnancy rate,ongoing pregnancy rate,and live birth rate than those in the delayed FET group(P>0.05).However,a significantly higher early miscarriage rate was depicted in the immediate FET group(22.0%vs.11.5%,P=0.009).The significance still existed after adjusting for potential confounders in the multiple logistic regression analysis(aOR=2.094,95%CI:1.138~3.852,P=0.018).Conclusions:Although the early miscarriage rate was significantly higher following the immediate FET,it produced a similar pregnancy rate than the delayed FET while reducing time to pregnancy and emotional stress.
作者
季慧
董丽
赵纯
凌秀凤
丁卉
JI Hui;DONG Li;ZHAO Chun;LING Xiu-feng;DING Hui(Center of Reproductive Medicine,Women′s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210004,China)
出处
《国际生殖健康／计划生育杂志》
CAS
2022年第3期189-194,共6页
Journal of International Reproductive Health/Family Planning
基金
国家自然科学基金(81971386)。
关键词
体外受精
胚胎移植
低温保存
妊娠结局
治疗
Fertilization in vitro
Embryo transfer
Cryopreservation
Pregnancy outcome
Therapy
