文章摘要
吴 畏,冒韵东,王 媁,丁 卫,黄 洁,刁飞扬,马 翔,刘嘉茵.不同内膜准备方案的1 372个冻融胚胎移植周期的临床治疗结局比较[J].南京医科大学学报,2010,(10):1469~1474
不同内膜准备方案的1 372个冻融胚胎移植周期的临床治疗结局比较
Comparison of the effect of different endometrial preparation methods on the clinical outcome of 1 372 frozen-thawed embryos transfer
投稿时间:2010-09-08  
DOI:10.7655
中文关键词: 冻融胚胎  胚胎移植  内膜准备  种植率  妊娠率  流产率  活产率
英文关键词: frozen-thawed embryo  embryo transfer  endometrial preparation  implantation rate  pregnancy rate  miscarriage rate  live birth rate
基金项目:国家973计划子课题(2006CB944005);江苏省卫生厅课题(H200905)
作者单位
吴 畏 南京医科大学第一附属医院生殖医学科,江苏 南京 210029 
冒韵东 南京医科大学第一附属医院生殖医学科,江苏 南京 210029 
王 媁 南京医科大学第一附属医院生殖医学科,江苏 南京 210029 
丁 卫 南京医科大学第一附属医院生殖医学科,江苏 南京 210029 
黄 洁 南京医科大学第一附属医院生殖医学科,江苏 南京 210029 
刁飞扬 南京医科大学第一附属医院生殖医学科,江苏 南京 210029 
马 翔 南京医科大学第一附属医院生殖医学科,江苏 南京 210029 
刘嘉茵 南京医科大学第一附属医院生殖医学科,江苏 南京 210029 
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中文摘要:
      目的:比较不同内膜准备方案的冻融胚胎移植(frozen-thawed embryo transfer, FET)的临床治疗结局?方法:回顾性分析了南京医科大学第一附属医院2007年1月至2009年7月冻融胚胎移植共1 372周期,其中自然周期冻融胚胎移植1 014周期,微刺激周期冻融胚胎移植358周期,微刺激周期中人绝经期促性腺激素(HMG)方案127周期?克罗米芬+HMG方案77周期?来曲唑+HMG方案154周期?比较各组患者年龄?不孕年限?基础内分泌(FSH?LH?E2)水平?移植日内膜厚度?平均移植胚胎数?移植胚胎级别?胚胎种植率?生化妊娠率?临床妊娠率?早期流产率?晚期流产率?活产率差异?结果:自然周期和微刺激周期冻融胚胎移植在胚胎种植率(26.7% vs 31.5%)?生化妊娠率(50.2% vs 57.5%)?临床妊娠率(43.5% vs 51.1%)?活产率(38.0% vs 44.9%)差异有统计学意义(P < 0.05),早期流产率(9.3% vs 9.8%)?晚期流产率(1.8% vs 1.6%)?异位妊娠率(1.6% vs 0.5%)差异无统计学意义;微刺激周期各用药组之间胚胎种植率?生化妊娠率?临床妊娠率?流产率及活产率差异无统计学意义?结论:适当的自然周期内膜监测或药物微刺激促排卵周期行FET内膜准备,较适合于冻融胚胎的移植?
英文摘要:
      Objective:To compare the effect of different endometrial preparation methods on the clinical outcome of frozen-thawed embryo transfer (FET). Methods:Total 1 372 FET cycles from January 2007 to July 2009 were retrospectively analyzed and divided into two groups:natural cycle group(n=1 014)and ovulation induction cycle group(n=358). The latter was further divided into three Sub groups:HMG cycle group(n=127),clomiphene citrate + HMG cycle group(n=77) and letrozole+HMG cycle group(n=154). The patient age,duration of infertility,basal FSH,LH and E2 levels,number of embryo transferred,embryo quality and endometrial thickness,the rates of embryo implantation,biochemical pregnancy,clinical pregnancy,early abortion,late abortion and live births were compared between these different groups. Results:FET cycle outcomes were similar between the nature cycle group and the ovulation induction cycle group on early abortion rates(9.3% vs 9.8%,P > 0.05),late abortion rates (1.8% vs 1.6%,P > 0.05) and ectopic pregnancy rates(1.6% vs 0.5%,P > 0.05). There were significant differences of the rates of embryo implantation (26.7% vs 31.5%,P < 0.05),biochemical pregnancy (50.2% vs 57.5%,P < 0.05),clinical pregnancy (43.5% vs 51.1%,P < 0.05) and live births (38.0% vs 44.9%, P < 0.05) between the two groups. The clinical pregnancy rates of three ovulation induction cycle groups were 54.5%,51.9%,42.8%,respectively in letrozole+HMG cycle group,the HMG group and the clomiphene citrate+HMG group. There were no significant differences among them. Conclusion:Endometrial preparation of natural cycle or proper ovulation induction cycle are very suitable for FET.
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