体外受精-胚胎移植后自然流产原因分析

摘要

目的：探讨在体外受精-胚胎移植（IVF-ET）助孕妊娠后发生自然流产的原因。方法：回顾性分析本中心行IVF-ET后临床妊娠的患者485例，分为早期流产（A组）、晚期流产（B组）及持续妊娠及分娩（C组），三组患者的年龄、不孕年限、Gn总量、Gn天数、获卵数、移植胚胎数、移植日内膜厚度、胚胎质量、受精方式及既往有无流产病史进行比较和分析。结果：A、B组患者的年龄、移植胚胎数均高于C组，差异均有统计学意义（P<0.05）；A、B组患者的获卵数、移植日内膜厚度明显低于C组，差异均有统计学意义（P<0.05）；A、B组患者既往自然流产史率明显高于C组，差异均有统计学意义（P<0.05）；B组患者多胎妊娠率明显高于A、C组，差异均有统计学意义（P<0.05）；三组间受精率、卵裂率、优胚率及受精方式比较差异均无统计学意义（P>0.05）。结论：高龄女性、有既往流产史的患者在IVF-ET助孕妊娠后发生自然流产的风险较高，而多胎妊娠是发生晚期自然流产的高危因素。%Objective:To investigate the in vitro fertilization-embryo transfer(IVF-ET)occurs causes of spontaneous abortion after pregnancy.Method:485 patients with clinical pregnancy after the center line of IVF-ET were retrospective analyzed,and divided into early abortion(group A),late abortion(group B)and ongoing pregnancy and childbirth patients(group C).The age,duration of infertility,total of Gn,few days of Gn,number of oocytes retrieved,number of embryos transferred, endometrial thickness on transplant day,embryo quality,fertilization methods and previous history of miscarriage of three groups were compared and analyzed.Result:The age and number of embryos transferred of group A and group B were higher than group C,the differences were statistically significant(P<0.05);oocytes and transplanting endometrial thickness of group A and group B were significantly lower than group C,the differences were statistically significant(P<0.05);previous history of spontaneous abortion rate of group A and group B were significantly higher than group C,the differences were statistically significant(P<0.05);group B with multiple pregnancy rate was significantly higher than group A and group C,the differences were statistically significant(P<0.05);the difference of fertilization rate,cleavage rate,excellent embryo fertilization rate and insemination of three groups were not statistically significant(P>0.05).Conclusion:The elderly woman and have a past history of miscarriage after IVF-ET patients in assisted reproduction pregnancy are higher risk of spontaneous abortion,and multiple pregnancy is a risk factor for the occurrence of late spontaneous abortion.