A frozen-thawed embryo transfer program improves the embryo utilization rate.
A frozen-thawed embryo transfer program improves the embryo utilization rate.
复制标题
冻融胚胎移植计划提高了胚胎利用率。
DOI：
--
复制
发表时间：
2009-09
期刊：
影响因子：
--
通讯作者：
张松英
中科院分区：
文献类型：
--
作者：
张松英
背景
冷冻-解冻胚胎移植（FET）是预防严重晚期卵巢过度刺激综合征和提高累积妊娠率的最常用方法。我们评估了FET方案在提高不孕症治疗中的胚胎植入率和临床妊娠率以及最终胚胎利用率方面的有效性。
方法
入选2006年1月至2008年6月接受体外受精（IVF）周期的患者，包括179例在控制性超促排卵（COH）后接受第一个FET周期的患者（C1组），其中所有胚胎均被冷冻，1306例COH合并新鲜胚胎移植（ET）（T1组）。根据母亲年龄、取卵数、移植胚胎数和移植优质胚胎数，采用Logistic回归分析建立胚胎植入率和临床妊娠率模型。在调整年龄、获卵数和移植胚胎数后，比较两组的胚胎种植率和临床妊娠率。
结果
Logistic回归分析证实，在调整混杂因素后，C1组的胚胎种植率和临床妊娠率均显著高于T1组（分别为43.6%vs29.0%，63.1%vs47.0%，P < 0.01）。C1组的胚胎种植率和临床妊娠率始终较高，与年龄组相比，C1组中≥ 35岁< 35 years. The clinical pregnancy rates for the numbers of oocytes retrieved per cycle being >或≥ 15岁或< 15岁的胚胎种植率较高。当卵母细胞数≥ 15个时，差异有统计学意义（P < 0.05）。C1组移植2枚或3枚胚胎的着床率和临床妊娠率均显著高于T1组（P < 0.05）。
结论
采用全胚胎冷冻和胚胎移植的方案，提高了胚胎种植率和临床妊娠率，最终提高了胚胎利用率。
BACKGROUND
Frozen-thawed embryo transfer (FET) is the most common way to prevent serious late ovarian hyperstimulation syndrome and increase the cumulative pregnancy rate. We evaluated the effectiveness of an FET program for improving the embryo implantation and clinical pregnancy rates, and ultimate embryo utilization rate in infertility treatment.
METHODS
Patients undergoing in vitro fertilisation (IVF) cycles from January 2006 to June 2008 were enrolled, including 179 patients who had undergone the first FET cycle after controlled ovarian hyperstimulation (COH) in which all embryos were frozen (group C1) and 1306 patients who had COH with fresh embryo transfer (ET) (group T1). Logistic regression was used to model the embryo implantation and clinical pregnancy rates based on the mother's age, numbers of oocytes retrieved, embryos transferred and high-quality embryos transferred. The embryo implantation and clinical pregnancy rates were also compared between two groups after adjusting for age, the numbers of oocytes retrieved and the numbers of embryos transferred.
RESULTS
Logistic regression analysis confirmed that embryo implantation and clinical pregnancy rates in group C1 were both significantly higher than those in group T1 after adjusting for confounding factors (43.6% vs 29.0%, 63.1% vs 47.0%, respectively; P < 0.01). The embryo implantation and clinical pregnancy rates were consistently higher in group C1 by comparing the age groups >or= 35 or < 35 years. The clinical pregnancy rates for the numbers of oocytes retrieved per cycle being >or= 15 or < 15 were higher in group C1, as was the embryo implantation rate. These differences were statistically significant for oocyte numbers >or= 15 (P < 0.05). The embryo implantation and clinical pregnancy rates in group C1 were both significantly higher than in group T1 when two or three embryos were transferred (P < 0.05).
CONCLUSION
A program of freezing all embryos and performing FET improved the rates of embryo implantation and clinical pregnancy, and ultimately enhanced the embryo utilization rate.