目的 比较拮抗剂方案中行新鲜胚胎移植和冻融胚胎移植的临床结局。 方法 回顾性分析2575例患者行拮抗剂方案助孕的临床资料，其中鲜胚移植周期1328例，冻胚移植周期1247例。 结果 冻胚移植组的血清AMH值、AFC显著高于鲜胚移植组，差异有统计学意义(P<0.05)，其余基础资料无统计学差异(P>0.05)。冻胚移植组hCG日FSH低于鲜胚移植组，E2、P高于鲜胚移植组，差异有统计学意义(P<0.05)。冻胚移植组的获卵数、成熟卵子数、优质胚胎数均显著高于鲜胚组，差异有统计学意义(P<0.05)。冻胚移植组的移植胚胎数显著低于鲜胚移植组，临床妊娠率、着床率、活产率显著高于鲜胚移植组，异位妊娠率、多胎妊娠率显著低于鲜胚移植组，差异有统计学意义(P<0.05)。两组的中重度OHSS发生率、流产率、妊娠期糖尿病发生率、妊娠期高血压发生率差异无统计学意义(P>0.05)。冻胚移植组的单胎出生体重显著高于鲜胚移植组，差异有统计学意义(P<0.05)。 结论 拮抗剂方案中冻胚移植亦可获得较好的临床结局，可作为一种有效的补充方案。
Abstract
Objective To compare the clinical outcomes of fresh embryo transfer and frozen-thawed embryo transfer (FET) in the gonadotropin-releasing hormone antagonist (GnRH-A) protocol. Method The clinical data of 2575 women undergoing GnRH antagonist protocol cycle, including 1328 cases of fresh embryo transfer and 1247 cases of FET were retrospectively analyzed. Results The AMH level and AFC in the FET group were significantly higher than those in the fresh embryo transfer group (P<0.05), and there was no significant difference in other baseline characteristics between the two group (P>0.05). The FSH level on hCG day in the FET group was significantly lower than that in the fresh embryo transfer group, and E2, P level on hCG day in the FET group were significantly higher than those in the fresh embryo transfer group (P<0.05). The total number of oocytes retrieved, matured oocyte, high-quality embryos in the FET group were significantly higher than those in the fresh embryo transfer group (P<0.05). The mean number of embryos transfer in the FET group was significantly lower than that in the fresh embryo transfer group, the clinical pregnancy rate, implantation rate and live birth rate in the FET group were significantly higher than those in the fresh embryo transfer group, the ectopic pregnancy rate and the multiple pregnancy rate in the FET group were significantly lower than those in the fresh embryo transfer group (P<0.05). There was no significant difference in the incidence of moderate-severe OHSS, miscarriage rate, incidence of GDM and gestational hypertension between the two groups (P>0.05). The singleton birth weight in the FET group was significantly higher than that in the fresh embryo transfer group, with statistical difference (P<0.05). Conclusions In the GnRH antagonist protocol cycle, FET can obtain good clinical outcome and can be used as an effective supplemental regimen.
关键词
拮抗剂方案 /
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新鲜胚胎移植 /
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冻融胚胎移植 /
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全胚冷冻
Key words
GnRH antagonist protocol /
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Fresh embryo transfer /
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Frozen-thawed embryo transfer /
Whole embryo freezing
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参考文献
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