北京大学学报(医学版) ›› 2013, Vol. 45 ›› Issue (6): 882-886.

• 论著 • 上一篇    下一篇

中国北方地区4所生殖中心全胚冻存策略应用临床结局分析

陈媛1,郝桂敏2,王秀霞3,张云山4,乔杰1,刘平1△   

  1. (1. 北京大学第三医院妇产科生殖医学中心,北京100191;2. 河北医科大学第二医院生殖医学中心,石家庄050000;3. 中国医科大学附属盛京医院辅助生殖中心,沈阳 110004;4. 天津中心妇产医院生殖医学中心,天津300100)
  • 出版日期:2013-12-18 发布日期:2013-12-18

Evaluation for the clinical application of all embryos cryopreservation: a multi-centre study in northern area of China

CHEN Yuan1, HAO Gui-min2, WANG Xiu-xia3, ZHANG Yun-shan4, QIAO Jie1, LIU Ping1△   

  1. (1. Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; 2. Center of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; 3. Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China; 4. Center of Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300100, China)
  • Online:2013-12-18 Published:2013-12-18

摘要: 目的:探讨全胚冻存策略的临床应用价值。方法:回顾性分析中国北方地区4家医院生殖中心在2011年4~9月期间9 055例全胚冻存患者的临床资料,按照全胚冻存的原因分为5组,即卵巢过度刺激综合征(ovarian hyperstimulation syndrome, OHSS)组、孕酮升高组、内膜因素组、输卵管积水组和其他原因组。分析首次解冻胚胎移植周期的临床妊娠率、着床率以及累计临床妊娠率。结果:OHSS组首次解冻胚胎移植周期的临床妊娠率、着床率以及累计临床妊娠率分别为55.4%、34.8%、73.7%,孕酮升高组分别为25.5%、11.2%、43.1%,内膜因素组分别为54.8%、34.4%、61.5%,输卵管积水组分别为60%、30%、60%,其他原因组分别为36.0%、24.5%、44.0%。结论:中、重度OHSS是全胚冻存策略的主要适应证之一,在新鲜周期移植前出现中、重度OHSS的患者,采用全胚冷冻策略可获得良好的临床妊娠结局。对于孕酮升高、内膜因素及有输卵管积水的患者(取卵后行输卵管积水处理),可借助全胚冻存策略,争取到较好的临床结局。

关键词: 胚胎处置, 低温保存, 受精, 体外, 胚胎移植, 治疗结果

Abstract: To investigate the clinical outcome of patients who underwent cryopreservation of all embryos. Methods: A retrospective analysis was made in the clinical data of patients with cryopreservation of all embryos between April 2011 and September 2011 in four hospitals of North China. The patients were divided into five groups according to the reasons of cryopreservation of all embryos: ovarian hyperstimulation syndrome (OHSS) group, serum progesterone elevation group, endometrial group, hydrosalpinx group and others. The clinical pregnancy rate per transfer, implantation rate and cumulative clinical pregnancy rate were analyzed. Results: The clinical pregnancy rate, implantation rate and cumulative clinical pregnancy rate of the OHSS group were 55.4%, 34.8% and 73.7%, respectively. The rates of the serum progesterone elevation group were 25.5%, 11.2% and 43.1%, respectively. The rates of the endometrial group were 54.8%, 34.4% and 61.5%, respectively. The rates of the hydrosalpinx group were 60%, 30% and 60%, respectively. The rates of the other factors group were 36.0%, 24.5% and 44.0%, respectively. Conclusion: The strategy of cryopreservation of all embryos could improve the clinical outcomes of patients with severe OHSS. It still needs a large multicentre, randomized trial to evaluate its effectiveness and side effects, although it has the positive clinical application for other reasons of cryopreservation of all embryos.

Key words: Embryo disposition, Cryopreservation, Fertilization in vitro, Embryo transfer, Treatment outcome

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