冻融胚胎移植138例临床分析.docVIP

冻融胚胎移植138例临床分析 【摘要】目的　比较冻融胚胎移植(FET)中3组用药方案的临床结局，探讨如何更好地选择FET的子宫内膜准备方案。方法　回顾分析138个FET周期，比较自然周期组、促排卵周期组及人工周期组3组临床用药方案在子宫内膜厚度、种植率、妊娠率、流产率上是否存在差异。结果　3组用药方案在年龄、不孕年限、移植胚胎个数和子宫内膜厚度上均无统计差异(P0.05)在临床妊娠率、种植率、流产率上的差异亦无统计学意义。结论　3组用药方案用于FET的子宫内膜准备均获得良好的临床结局。个体化用药方案可根据患者的情况选择进行FET。 【关键词】 冻融胚胎;胚胎移植;内膜准备;妊娠率;种植率;用药方案 Abstract：Objective　To compare the clinical outcome of 3 protocols of frozen-thawed embryo transfer cycle to select the optional endometrial preparation method for frozen-thawed transfer. 　Methods　To retrospectively analyze the natural and HRT rotocols in endometrial preparation for 138 frozen-thawed embryos transfer cycle. A retrospective analysis of the 3 clinical protocols was conducted including natural cycle， hormone replacement treatment cycle， HMG cycle ，and the clinical pregnancy rate， implantation rate， early abortion rate， ongoing pregnancy rate were comprared arnong 3 protocols.　Results　There was no significant difference arnong 3 groups with different clinical protocols in age，duration of infertility， reason of infertility， number of embryo transfer and endometrial thickness，pregnancy rate，implantation rate，quality of embryo transfer.There was no significant difference in endometrial thickness. The 3 protocols differed little in the implantation rate，clinital pregnancy rate，biochemical pregnancy rate， early abortion rate， ongoing pregnancy rate in the three clinical protocols. 　Conclusion　The 3 clinical protocols for frozen-thawed embryos transfer all have favorable clinical outcome，and choice of a specific protocol should be made according to the comprehensive consideration of the individual conditions of each patient. Key words：frozen-thawed embryo; embryo transfer; endometrial preparation; pregnancy rate; implantation rate; clinical protocol 自1983年澳大利亚取得世界首例人类冻融胚胎移植(FET)临床妊娠成功以来，FET技术迅速发展并被广泛推广，其在提高累积妊娠率、预防卵巢过度刺激征(OHSS)、降低多胎率以及降低费用等方面也发挥着越来越重要的作用。因此冻融胚胎移植(FET)已成为体外受精-胚胎移植(IVF-ET)不可缺少的一部分。目前在进行冷冻胚胎移植时，多采用自然周期、激素替代周期、促排卵周期等临床方案准备内膜，使胚胎与子宫内膜同步化，提高FET的移植成功率。