体外受精-胚胎移植妊娠结局的影响因素探究

马丽影; 许晓婷; 窦倩; 赵冬梅; 项云改; 李朋粉; 谭丽

doi:10.12182/20220160205

体外受精-胚胎移植妊娠结局的影响因素探究

Influencing Factors of Pregnancy Outcome of in vitro Fertilization-Embryo Transfer

摘要

摘要:
目的分析囊胚移植相关因素对体外受精-胚胎移植妊娠结局的影响。
方法回顾性分析2015年7月−2020年7月期间在我院接受体外受精-胚胎移植的790例患者的临床资料，比较第5天胚胎囊胚（D5）组（n=705）和第6天胚胎囊胚（D6）组（n=85）囊胚移植的妊娠结局；依据妊娠结局分为活产组（n=322）和非活产组（n=468），多因素logistic分析体外受精-胚胎移植后活产结局的囊胚移植相关影响因素。
结果 D5组囊胚移植的生化妊娠率、临床妊娠率和活产率（分别为69.93%、64.96%、41.84%）均高于D6组（50.59%、45.88%、30.59%）囊胚移植，差异有统计学意义（P<0.05）；D5组和D6组囊胚移植的流产率比较差异无统计学意义。多因素logistic分析显示，年龄>35岁、不孕年限>5年、移植日内膜厚度<9 mm、滋养层细胞评级为C级、囊胚移植日为D6、多产均为体外受精-胚胎移植非活产的危险因素（P<0.05）。
结论年龄、不孕年限、移植日内膜厚度、滋养层细胞评级、囊胚移植日、多产均与体外受精-胚胎移植的不良妊娠结局相关，应积极监测，采取有效措施预防不良妊娠结局。

Abstract:
Objective To analyze the effect of factors relevant to blastocyst transfer on the pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET).
Methods The clinical data of 790 pregnant women who underwent IVF-ET in our hospital from July 2015 to July 2020 were retrospectively analyzed. The pregnancy outcome of blastocysts transferred on day 5 (D5, n=705) and those transferred on day 6 (D6, n=85) were compared. According to the pregnancy outcome, the cases were divided into a live birth group (n=322) and a non-live birth group (n=468), and multivariate logistic regression was conducted to study the effect of factors relevant to blastocyst transfer on the live birth outcome of IVF-ET.
Results In the D5 group, the biochemical pregnancy rate, clinical pregnancy rate and live birth rate of blastocyst transfer were 69.93%, 64.96%, and 41.84%, respectively, which were significantly higher than those of the D6 group at 50.59%, 45.88%, and 30.59%, respectively. The difference was statistically significant (P<0.05). There was no statistically significant difference in the miscarriage rate between the D5 group and the D6 group (P>0.05). Multivariate logistic analysis revealed that age>35 years, years of infertility>5 years, endometrium thickness<9 mm on the day of blastocyst transfer, trophoblast cell rating of C, blastocyst transfer performed on D6, and multiparity were all risk factors for non-live birth outcome of IVF-ET (P<0.05).
Conclusion The adverse pregnancy outcomes of IVF-ET were found to be associated with age, duration of infertility, endometrial thickness on the day of to blastocyst transfer, trophoblast cell rating, and blastocyst transfer performed after how many days of embryo development, and multiparity, which should be closely monitored, and effective measures should be adopted accordingly to prevent adverse outcomes of pregnancy.

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