冻融胚胎与新鲜胚胎移植对OHSS高危人群临床妊娠结局的影响研究

发布时间：2018-06-18 22:47

本文选题：卵巢过度刺激综合征 + 体外受精-胚胎移植　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:本研究主要是探讨除外PCOS的OHSS高风险人群分别全胚冷冻后首次冻融胚胎移植(FET)与新鲜胚胎移植后两组患者的OHSS发生率、临床及实验室相关指标和临床结局是否有差异。方法:研究对象为2014年1月-2015年12月于河北医科大学第二医院生殖医学科接受IVF/ICSI助孕患者,且为除外PCOS的OHSS高风险人群。依据移植方式分为新鲜胚胎移植组和全胚冷冻首次冻融胚胎移植组。通过收集临床及实验室数据,比较两组患者在接受COH治疗后相关实验室、临床指标及妊娠结局。结果:1一般情况基础窦卵泡数:冻融胚胎移植组显著性高于新鲜胚胎移植组(P=0.000)。余一般情况,两组比较无显著性差异(P0.05)。2促排卵期间参数比较Gn起步计量及应用天数:冻融胚胎移植组显著性低于新鲜胚胎移植组(P=0.014,P=0.030)。HCG日E2、P水平:冻融胚胎移植组显著性高于新鲜胚胎移植组(P=0.000,P=0.000)3体外受精情况比较平均获卵数、平均可移植胚胎数:冻融胚胎移植组显著性高于新鲜胚胎移植组(P=0.000,P=0.000)。Gn/N比较:冻融胚胎移植组显著性低于新鲜胚胎移植组(P=0.000)。4临床结局平均出生婴儿体重、双胎婴儿平均体重:冻融胚胎移植组显著性高于新鲜胚胎移植组(P=0.044,P=0.001)临床妊娠率、流产率、早产率等A、B两组无显著性差异。5并发症中重度OHSS发生率:冻融胚胎移植组低于新鲜胚胎移植组,但两组间无显著性差异(P=0.38)6 Logistic回归分析影响妊娠率与OHSS发病率的相关因素通过Logistic回归结论得出影响本中心OHSS高危人群妊娠成功率的主要因素是获卵数。由于OHSS发病率低、本次试验样本量小,未获得影响OHSS发病率的影响因素。结论:1 OHSS高危人群全胚冷冻有利于降低OHSS发生率,但不影响妊娠率。2全胚冷冻复苏周期胚胎移植患者的子代体重增加,提示冻胚移植对子代更有利,尚需进一步扩大样本量。
[Abstract]:Objective: this study was to investigate the OHSS incidence, clinical and laboratory indicators and clinical outcomes of patients with high risk of OHSS except PCOS in the first frozen thawed embryo transfer (FETT) group and the fresh embryo transfer group (FET). Methods: the subjects of the study were IVF / ICSI assisted pregnancy patients who received IVF / ICSI from January 2014 to December 2015 in the Department of Reproductive Medicine, second Hospital of Hebei Medical University, and OHSS high-risk population excluding PCOS. It was divided into fresh embryo transfer group and whole embryo freeze thawed embryo transfer group. By collecting clinical and laboratory data, the laboratory, clinical indexes and pregnancy outcome were compared between the two groups after COH treatment. Results the number of basic antral follicles was significantly higher in the frozen-thawed embryo transfer group than in the fresh embryo transfer group. In general, There was no significant difference between the two groups in the comparison of parameters during ovulation promotion period: the number of days of initial measurement and application of Gn: the level of E2P in frozen thawed embryo transfer group was significantly lower than that in fresh embryo transfer group. HCG day E2P level was significantly higher in frozen and thawed embryo transfer group than in fresh embryo transfer group. In the embryo transfer group, the average number of eggs obtained was compared with that of in vitro fertilization. The average number of embryos transfered: the average birth weight of frozen thawed embryo transfer group was significantly higher than that of fresh embryo transfer group, compared with that of fresh embryo transfer group (P 0.000). Gn / N comparison showed that the clinical outcome of frozen and thawed embryo transfer group was significantly lower than that of fresh embryo transfer group (P = 0.000), and the mean birth weight of clinical outcome was lower in frozen thawed embryo transfer group than that in fresh embryo transfer group. The average body weight of twin infants was significantly higher in frozen thawed embryo transfer group than that in fresh embryo transfer group. There was no significant difference in the rate of premature delivery between the two groups. 5 the incidence of moderate and severe OHSS complications in the frozen-thawed embryo transfer group was lower than that in the fresh embryo transfer group. But there was no significant difference between the two groups. Logistic regression analysis showed that the main factor influencing the success rate of pregnancy in the high risk population of OHSS was the number of eggs. Because of the low incidence of OHSS and the small sample size, no factors affecting the incidence of OHSS were obtained. Conclusion cryopreservation of whole embryo in the high risk population of 1 / 1 OHSS is beneficial to reduce the incidence of OHSS, but it does not affect the weight gain of the offspring of embryo transfer in the whole embryo cryopreservation resuscitation cycle of pregnancy rate .2, suggesting that frozen embryo transplantation is more beneficial to the offspring, and the sample size needs to be further expanded.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.8

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