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目的:通过分析复融新鲜胚胎混合周期移植的妊娠结局,探寻改善高龄、反复助孕失败患者妊娠结局的方法。方法:回顾分析2014年4月至2016年4月在河南省人民医院生殖医学研究所行常规体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSIET)患者的临床资料。根据移植胚胎类型、数量,设置A组(新鲜周期移植D3新鲜胚胎1枚及D3冷冻复苏胚胎1枚,36个周期)、B组(复苏周期移植D3冷冻复苏胚胎1枚,62个周期)和C组(复苏周期移植D3冷冻复苏胚胎2枚,62个周期)、D组(新鲜周期移植D3新鲜胚胎1枚,62个周期)和E组(新鲜周期移植D3新鲜胚胎2枚,62个周期)。比较各组的胚胎种植率、生化妊娠率、临床妊娠率、多胎率和流产率等指标。结果:5组患者中,混合周期患者的既往助孕周期数显著高于其他各组(P<0.05)。5组的妊娠结局、早期流产率、流产率及新生儿出生性别比差异无统计学意义(P>0.05),生化妊娠率、临床妊娠率、胚胎种植率、异位妊娠率、畸形率比较,差异有统计学意义(P<0.05)。A组能获得相对较高的生化妊娠率、临床妊娠率和胚胎种植率。结论:对于可利用胚胎数目较少的高龄反复种植失败的患者,可依据情况建议其采用混合周期移植以改善妊娠结局。
OBJECTIVE: To analyze the pregnancy outcome of mixed cycle transplant of fresh embryo reconstituted and to explore the method of improving pregnancy outcome in elderly patients with failed pregnancy. Methods: The clinical data of routine in vitro fertilization / intracytoplasmic sperm injection / embryo transfer (IVF / ICSIET) from April 2014 to April 2016 in Reproductive Medicine Institute of Henan Provincial People’s Hospital were retrospectively analyzed. Group A (fresh embryo transfer D3 fresh embryo and D3 cryopreservation embryo 1, 36 cycles), group B (resuscitation cycle replant D3 cryopreservation embryo 1, 62 cycles) and group B Group C (2 resuscitation cycles of D3 cryopreservation embryos, 62 cycles), Group D (fresh embryo transfer of D3 fresh embryos of 1, 62 cycles) and Group E (fresh cycles of D3 fresh embryos transferred 2, 62 cycles ). The embryo implantation rate, biochemical pregnancy rate, clinical pregnancy rate, multiple pregnancy rate and miscarriage rate of each group were compared. Results: Among the five groups, the number of previous assisted pregnancies in patients with mixed cycles was significantly higher than that in other groups (P <0.05). There was no significant difference in pregnancy outcome, early miscarriage rate, miscarriage rate and newborn birth sex ratio among the 5 groups (P> 0.05), biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate, ectopic pregnancy rate, malformation rate, The difference was statistically significant (P <0.05). A group can get a relatively high rate of biochemical pregnancy, clinical pregnancy rate and embryo implantation rate. CONCLUSIONS: For patients with fewer older embryos who may have fewer embryos available, mixed cycle transplantation may be recommended to improve pregnancy outcomes, as appropriate.