轻度子宫内膜异位症患者全胚冷冻后首次冻融胚胎移植助孕结局分析

摘要

Objective:To explore the outcome of the first frozen-thawed embryo transfer(FET)cycle after whole embryo cryopreservation in the patients with mild endometriosis.Methods:The data of 521 IVF-ET/ICSI cycles including 419 cycles of the first FET cycle after whole embryo cryopreservation and 102 cycles of the fresh embryo transfer during the same period in our reproductive center were retrospectively analyzed.The general characteristic and clinical outcomes were compared between the two groups.Results:There were no significant differences in age,infertility year,infertility types,number of antral follicles,basic levels of E2 & FSH,CA-125 value before laparoscopic surgery,body mass index,antimullerian hormone level,pathology types,and proportion of the protocols of controlled ovarian stimulation were not significantly different between two groups(P＞0.05).CA-125 level before IVF/ICSI in the FET group was significantly lower than that in the fresh cycle group [(15.611.2)vs.(20.7+14.3)U/ml] (P＜0.05).The ra±io of GnRH-a treatment cycle after laparoscopic surgery in the FET group was significantly higher than that in the fresh cycle group(68.7％ vs.55.9％,P＜0.05).The high quality embryo rate in the FET group was significantly lower than that in the fresh cycle group(40.9％ vs.47.7％,P＜0.05).There were no significant differences in the implantation rate and the clinical pregnancy rate between the two groups(P＞0.05).The early abortion rate was significantly lower(6.7％ vs.14.6％)and live birth rate was significantly higher(33.7％ vs.28.4％)in the FET group than that in the fresh cycle group(all P＜0.05).Conclusions:The clinical pregnancy rate is similar,but the early abortion rate is lower and the live birth rate is higher in the first FET cycle after whole embryo cryopreservation compared with the fresh embryo transfer cycle in patients with mild endometriosis.%目的 探讨轻度子宫内膜异位症患者全胚冷冻后首次冻融胚胎移植(FET)的助孕结局.方法 选取成都市妇女儿童中心医院生殖中心轻度子宫内膜异位症患者行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)的521个助孕周期进行回顾性分析,选取其中行全胚冷冻后首次FET的419个周期为研究组,同期的102个新鲜胚胎移植周期为对照组,比较两组的一般资料及妊娠结局.结果 两组间年龄、不孕年限、不孕类型、窦卵泡数目、基础FSH、基础E2、腹腔镜术前癌胚抗原(CA-125)值、体重指数、抗苗勒氏管激素水平、临床病理类型比例及各控制性促排卵方案比例等比较均无显著性差异(P＞0.05);研究组中助孕前CA-125下降幅度显著低于对照组[(15.6士11.2)U/ml vs.(20.7±14.3 U/ml)](P＜0.05);研究组术后GnRH-a治疗周期比例显著高于对照组(68.7％ vs.55.9％)(P＜0.05);研究组优质胚胎率显著低于对照组(40.9％vs.47.7％)(P＜0.05).两组间胚胎种植率、临床妊娠率比较无显著性差异(P＞0.05);研究组早期流产率显著低于对照组(6.7％vs.14.6％),而活胎分娩率显著高于对照组(33.7％ vs.28.4％)(P均＜0.05).结论 轻度子宫内膜异位症患者全胚冻存后首次行FET其临床妊娠率与鲜胚移植相似,但早期流产率更低,活胎分娩率更高.