摘要
目的 探究宫腔粘连(IUA)分离术后患者冻融周期囊胚移植的助孕策略及其影响因素。方法收集因不孕因素行冻融周期囊胚移植的IUA分离术后患者275例,分成单囊胚移植组(n=182)与双囊胚移植组(n=93),对两组患者临床结局进行回顾性分析。结果 两组患者在年龄、转化日子宫内膜厚度、内膜准备方式、临床妊娠率、流产率、早产率、分娩孕周、分娩方式之间的比较,差异无统计学意义(P>0.05)。单囊胚移植组的不孕年限(2.43±1.64)年,AFS预后评分(5.13±2.25)分,多胎率1.33%低于双囊胚移植组的不孕年限(3.03±2.13)年,AFS预后评分(5.72±2.19)分,多胎率28.57%;单囊胚移植组的优胚率90.66%,种植率50.00%,活婴体质量(3 236.84±565.35)g高于双囊胚移植组的优胚率46.24%,种植率34.41%,活婴体质量(2 976.44±692.79)g,差异有统计学意义(P <0.05)。logistic回归分析显示,移植优质胚胎数目、AFS评分是临床妊娠的独立影响因素(P <0.05)。结论 冻融周期囊胚移植IUA术后患者的移植优质胚胎数目、AFS评分是临床妊娠的独立影响因素。优质单囊胚移植是IUA分离术后患者行冻融周期治疗的首选,对于低预后IUA术后患者可以选择双囊胚移植有助于获得更好的妊娠结局。
Objective To explore the assisted reproductive strategy and influencing factors for patients undergoing frozen-thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for intrauterine adhesions.Methods A total of 275 patients who underwent frozen-thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for infertility reasons at the Reproductive Genetics Center of the First Affiliated Hospital of University of Science and Technology of China from January 2018 to December 2022 were included in the study.They were divided into a single blastocyst transfer group(n=182)and a double blastocyst transfer group(n=93).The clinical outcomes were analyzed and compared retrospectively between the group.Results The two groups showed no statis-tically significant differences in terms of age,day of endometrial thickness conversion,endometrial preparation method,clinical pregnancy rate,miscarriage rate,preterm birth rate,gestational week at delivery,and mode of delivery(P>0.05).The single blastocyst transfer group had significantly lower infertility duration(years)(2.43±1.64 vs.3.03±2.13,P<0.05),significantly lower AFS prognosis score(5.13±2.25 vs.5.72±2.19,P<0.05),and significantly lower multiple pregnancy rate(1.33%vs.28.57%,P<0.05),but significantly higher quality embryo rate(90.66%vs.46.24%,P<0.05),implantation rate(50.00%vs.34.41%,P<0.05),and live infant mass(g)(3236.84±565.35 vs.2976.44±692.79,P<0.05)compared to the double blastocyst transfer group.Binary logistic regression analysis showed that the number of high-quality embryos transferred and AFS score were independent influencing factors for clinical pregnancy(P<0.05).Conclusions The number of high-quality embryos transferred and the AFS score are independent influencing factors for clinical pregnancy in patients undergoing frozen-thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for intrauterine adhesions.Single high-quality blastocyst transfer is a preferred treatment for patients after hysteroscopic adhesiolysis,and double bl
作者
刘程
桑美英
方群英
白顺
胡美红
郑圣霞
LIU Cheng;SANG Meiy-ing;FANG Qunying;BAI Shun;HU Meihong;ZHENG Shengxia(Center for Reproduction and Genetics,the First Af-filiated Hospital,USTC,Hefei 230001,China)
出处
《实用医学杂志》
CAS
北大核心
2024年第17期2390-2394,共5页
The Journal of Practical Medicine
基金
国家自然科学基金项目(编号:81971339)。
关键词
宫腔粘连
冻融周期
囊胚
因素
妊娠结局
intrauterine adhesion
frozen-thawed cycle
blastocyst
factors
pregnancy outcome
