胚胎冷冻保存时间对首次冻融胚胎移植临床结局和出生子代的影响OACSTPCD
Effects of storage time on clinical pregnancy and neonatal outcomes of the first frozen embryo transfer
目的 探讨胚胎冷冻保存时间对首次冻融胚胎移植(FET)妊娠结局和出生子代的影响.方法 回顾性分析2014年1月至2022年6月期间在江西省妇幼保健院辅助生殖中心行首次FET的4 075例妇女的临床资料.根据胚胎冻存时间分为4组:A组(胚胎冻存≤3个月,n=993)、B组(胚胎冻存4～6个月,n=1 757)、C组(胚胎冻存7～12个月,n=880)和D组(胚胎冻存13～24个月,n=445),比较各组患者的一般资料、胚胎移植情况、妊娠结局和新生儿结局,采用多元Logistic回归分析胚胎冻存时间对妊娠结局和新生儿结局的影响.结果 4组患者的胚胎冻存时间、女方取卵年龄、体质量指数(BMI)、原发不孕占比等一般资料有显著性差异(P＜0.05).4组患者间获卵数、可利用胚胎数、冷冻年份、内膜准备方案和单胚胎移植率比较有显著性差异(P＜0.01),囊胚移植率无显著性差异(P＞0.05).4组患者FET后的临床妊娠率、多胎率、流产率等均无显著性差异(P＞0.05);A～D组的活产率分别为50.86％、53.27％、49.55％和51.01％,组间无显著性差异(P＞0.05).单胎活产婴儿的出生结局比较,4组新生儿的早产率、极早产率、低出生体重率、极低出生体重率、巨大儿率、男女性别比和出生缺陷发生率等均无显著性差异(P＞0.05).多元Logistic回归分析结果显示,胚胎冻存时间对活产率、β-HCG阳性率、临床妊娠率、种植率、流产率和早产率等均无显著影响(P＞0.05).结论 胚胎玻璃化冻存2年内,胚胎冻存时间不影响首次FET的活产率,也不增加早产、低出生体重和出生缺陷发生风险.
Objective:To explore the effects of embryo storage time after vitrification on clinical pregnancy and neonatal outcomes for the first frozen embryo transfer cycle. Methods:A retrospective cohort study was conducted on 4 075 women who underwent the first frozen embryo transfer after fresh embryo transfer in Assisted Reproductive Center of Jiangxi Maternal and Child Health Hospital from January 2014 to June 2022.According to the storage time,the patients were divided into four groups:group A(≤3 months,n=993),group B(4 to 6 months,n=1 757),group C(7 to 12 months,n=880),and group D(13 to 24 months,n=445).Baseline characteristics,the embryo transfer,clinical pregnancy and neonatal outcomes among four groups were compared,and multiple logistic regression model was used to analyze the impact of embryo storage time on pregnancy and neonatal outcomes. Results:There were significant differences in embryo cryopreservation time,age at the time of egg retrieval,body mass index(BMI),and the proportion of primary infertility among the four groups(P＜0.05).There were significant differences in the number of retrieved eggs,available embryos,the year of embryo freezing,endometrial preparation scheme,and single embryo transfer rate among the four groups(P＜0.01),while there was no significant difference in the blastocyst transfer rate among the four groups(P＞0.05).There were no significant differences in clinical pregnancy rate,multiple pregnancy rate,and the miscarriage rate among the four groups after FET(P＞0.05).The live birth rates of group A,B,C and D after first frozen embryo transfer were 50.86％,53.27％,49.55％ and 51.01％,respectively,showing no significant differences among the four groups(P＞0.05).As for all singletons born after frozen embryo transfer,no significant differences in preterm birth,very preterm birth,low birth weight,very low birth weight,fetal macrosomia,sex ratio and birth defects were observed among the four groups(P＞0.05).The results of multiple logistic regression showed that embryo storage time had no significant effects on live birth rate,β-HCG positive rate,clinical pregnancy rate,the implantation rate and the miscarriage rate. Conclusions:The storage time within 2 years does not affect the live birth rate after the first frozen embryo transfer,nor does it increase the risk of preterm birth,low birth weight and birth defects.
吴兴武;夏雷震;黄志辉;辛才林;田莉峰;伍琼芳
江西省妇幼保健院辅助生殖中心,南昌 330108
临床医学
保存时间妊娠结局出生子代冻融胚胎移植
Storage timePregnancy outcomeOffspringFrozen embryo transfer
《生殖医学杂志》 2024 (005)
592-598 / 7
江西省卫生健康委科技计划(20195490);江西省中医药管理局科技计划(2022A256)
评论