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目的:探讨重复性异位妊娠的发生与移植日胚胎发育天数的关系。方法:回顾性分析741个冻融胚胎移植(FET)周期且有明确异位妊娠病史患者的临床资料。按胚胎体外培养时间分为卵裂组,复融第3日胚胎(n=458);囊胚组,复融第5或第6日囊胚(n=283)。比较组间患者的一般情况及治疗情况。结果:组间患者的平均年龄、平均不孕年限、既往异位妊娠病史、输卵管手术史、内膜准备方案、内膜厚度等差异无统计学意义(P>0.05),囊胚组平均移植胚胎数低于卵裂组(1.9±1.3 vs 2.0±0.5,P<0.05),临床妊娠率、双胎妊娠率囊胚组高于卵裂组(75.97%vs 42.36%,57.20%vs 31.40%,P<0.05),流产率、重复异位妊娠率囊胚组低于卵裂组(6.97%vs 16.49%,0.82%vs 5.15%,P<0.05)。结论:有异位妊娠病史的患者,囊胚移植可降低重复异位妊娠的发生风险。
Objective: To investigate the relationship between the occurrence of repetitive ectopic pregnancy and the days of embryo development on the day of transplantation. Methods: A retrospective analysis of 741 frozen-thawed embryo transfer (FET) cycles and a clear history of ectopic pregnancy in patients with clinical data. According to the embryo culture time divided into cleavage group, reconstitution day 3 embryos (n = 458); blastocyst group, reconstructing the 5th or 6th day blastocysts (n = 283). Compare the general situation and treatment of patients in the group. Results: There was no significant difference in average age, average duration of infertility, history of previous ectopic pregnancy, history of tubal surgery, endometrial preparation plan and intima thickness between groups (P> 0.05) (1.9 ± 1.3 vs 2.0 ± 0.5, P <0.05). The clinical pregnancy rate and twin pregnancy rate in blastocyst group were higher than those in cleavage group (75.97% vs 42.36%, 57.20% vs 31.40%, P <0.05). Abortion rate and repeated ectopic pregnancy rate in blastocyst group were lower than that in cleavage group (6.97% vs 16.49%, 0.82% vs 5.15%, P <0.05). CONCLUSION: In patients with a history of ectopic pregnancy, blastocyst transfer reduces the risk of repeated ectopic pregnancies.