自然周期与替代周期准备内膜对冷冻胚胎移植结局的影响
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The effect of nature cycle and hormone replacement treatment cycle on the outcome of frozen-thawed embryo transfer
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    目的:探讨自然周期与替代周期法准备内膜对冷冻胚胎移植结局的影响-方法:在冷冻胚胎移植周期中,分别采用自然周期(n=149)-替代周期(n=578)准备内膜,比较周期妊娠率-流产率-种植率-多胎妊娠率等指标-结果:2组移植周期临床妊娠率分别为39.6%-41.2%(P > 0.05);流产率分别为5.4%-5.0%(P > 0.05);种植率分别为28.3%-27.6%(P > 0.05)-冷冻囊胚移植妊娠率66.7%,分裂期胚胎移植妊娠率39.9%,差异有显著性(P < 0.05)-自然周期与替代周期相比单胎-多胎妊娠率差异无显著性(P > 0.05)-移植3个胚胎妊娠率较移植2个胚胎显著增加,多胎妊娠率显著增加(P < 0.05)-结论:在冷冻胚胎移植周期,采用自然周期或替代周期法准备内膜的妊娠率-流产率无明显差异,对于排卵正常患者采用自然周期法更经济-简单,增加移植胚胎数在提高妊娠率的同时明显提高了多胎妊娠率-

    Abstract:

    Objective:To analyze the effect of nature cycle and hormone replacement treatment(HRT) cycle on the outcome of frozen-thawed embryo transfer(FET). Methods:In this retrospective study,727 FET cycles were divided into 2 groups:nature cycle(n=149) and HRT cycle(n=578). Pregnancy rate,spontaneous abortion rate,implantation rate and multiple pregnancy rate were compared between two groups. Results:FET cycle outcomes were similar between nature cycle and HRT cycle on pregnancy rates (39.6% vs 41.2%,P > 0.05),spontaneous abortion rates(5.4% vs 5.0%,P > 0.05),implantation rates(28.3% vs 27.6%,P > 0.05). There were significant differences of pregnancy rates between cleavage FET cycle and blastocyst FET cycle(66.7% vs 39.95,P < 0.05). There were no significant differences of monocyesis pregnancy rates and multiple pregnancy rates between nature cycle and HRT cycle(P > 0.05).Transfer with 3 embryos resulted in higher pregnancy rate and multiple pregnancy rate than transfer with 2 embryos (P < 0.05). Conclusions:FET cycle outcomes were similar between nature cycle and HRT cycle on pregnancy rate and spontaneous abortion rate. It should be more economical and easier for ovulatory patients to use nature cycle FET. Increasing number of FET embryo was associated with improved pregnancy rate and higher multiple pregnancy rate.

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陈〓华,孙海翔,王慧焱,王〓玢.自然周期与替代周期准备内膜对冷冻胚胎移植结局的影响[J].南京医科大学学报(自然科学版),2010,(2):245-248

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