新鲜和冻融胚胎移植周期异位妊娠发生率及危险因素分析

发布时间：2018-07-08 16:04

本文选题：异位妊娠(EP) + 新鲜周期　；参考：《生殖与避孕》2015年09期

【摘要】：目的:分析新鲜周期和冻融周期异位妊娠(EP)的发生情况及相关危险因素。方法:回顾分析接受助孕治疗的患者12 209例,共19 144个周期的临床资料,其中新鲜周期移植13 170个、冻融周期5 974个,分析输卵管因素、盆腔手术史、EP手术史、子宫内膜异位症(EMs)及多囊卵巢综合征(PCOS)等因素对异位妊娠发生的影响。结果:新鲜移植周期临床妊娠率显著高于冻融周期(50.12%vs 40.16%),新鲜周期组中IVF-ET周期EP发生率显著高于ICSI-ET组(3.54%vs 1.76%),差异均有统计学意义(P0.01)。冻融周期异位妊娠率高于新鲜周期组(3.37%vs 3.19%),冻融周期组中激素替代周期EP率高于自然周期(3.48%vs 3.25%),但差异均无统计学意义(P0.05)。新鲜周期组内,输卵管因素、盆腔手术史、EP手术史均可使EP率较之未合并该危险因素者显著增加(依次为3.51%vs 2.61%;4.57%vs 2.86%;4.99%vs 3.00%),差异有统计学意义(P0.05)。冻融周期组内,输卵管因素、盆腔手术史、EP手术史亦均可使EP率较之未合并该危险因素者显著增加(依次为4.25%vs 1.69%;7.64%vs 2.67%;11.03%vs 2.88%),差异有统计学意义(P0.05)。新鲜周期和冻融周期组内比较,有EMs者较之无EMs,有PCOS者较之无PCOS者,EP发生率的差异均无统计学意义(P0.05)。另将19 144个周期分别依据有无EMs或PCOS分组进行比较,有EMs者EP率高于无EMs者(1.92%vs 1.51%;P0.05),有PCOS者异位妊娠率高于无PCOS者(3.54%vs1.40%;P0.01)。结论:冻融周期胚胎移植后EP率略高于新鲜周期;输卵管因素、盆腔手术史、EP手术史是助孕治疗患者EP发生的主要危险因素,合并EMs或PCOS也是EP发生的重要因素。
[Abstract]:Objective: to analyze the incidence and risk factors of ectopic pregnancy (EP) in fresh and frozen-thawed cycles. Methods: the clinical data of 12 209 patients who received assisted pregnancy therapy were retrospectively analyzed, including 13 170 fresh cycles of transplantation and 5 974 cycles of freezing and thawing. The factors of fallopian tube and the history of pelvic surgery were analyzed. Effects of endometriosis (EMs) and polycystic ovary syndrome (PCOS) on ectopic pregnancy. Results: the clinical pregnancy rate of fresh transplantation group was significantly higher than that of freeze-thaw cycle (50.12%vs 40.16%), and the incidence of EP in fresh cycle group was significantly higher than that in ICSI-ET group (3.54%vs 1.76%). The difference was statistically significant (P0.01). Ectopic pregnancy rate in freeze-thaw cycle was higher than that in fresh cycle group (3.37%vs 3.19%), EP rate in freeze-thaw cycle group was higher than that in natural cycle group (3.48%vs 3.25%), but there was no significant difference (P0.05). In fresh cycle group, fallopian tube factor, pelvic surgery history and EP operation history could significantly increase EP rate (3.51%vs 2.61 and 4.57 vs 2.86 vs 4.99% vs 3.00%), the difference was statistically significant (P0.05). In the freeze-thaw cycle group, oviduct factor, pelvic surgery history and EP operation history also significantly increased the EP rate (4.25%vs 1.697.64 vs 2.67g / 11.03 vs 2.88%), and the difference was statistically significant (P0.05). In fresh cycle and freeze-thaw cycle group, there was no significant difference in the incidence of EP between the patients with EMs and those with PCOS compared with those without PCOS (P0.05). In addition, 19 144 cycles were compared according to whether there were EMs or PCOS. The EP rate in EMs group was higher than that in non EMs group (P 0.05), and the ectopic pregnancy rate in PCOS group was higher than that in non PCOS group (3.54 vs 1.40% P0.01). Conclusion: the EP rate after embryo transplantation in freeze-thawing cycle is slightly higher than that in fresh cycle, the factors of fallopian tube, pelvic surgery and EP are the main risk factors of EP, and the occurrence of EP is also associated with EMs or PCOS.
【作者单位】：广州医科大学附属第三医院生殖医学中心广东省生殖医学重点实验室广州妇产科研究所;
【基金】：广东省科技计划(粤科规财字[2014]116号2013B021800188) 广东省人口计生委(粤人口计生办[2013]30号,20133064) 广东省生殖医学重点实验室项目(粤科财字[2012]125号) 广东省普通高校生殖与遗传重点实验室项目(粤教科字[2011]85号)资助项目
【分类号】：R714.8

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