国际妇产科学杂志

国际妇产科学杂志 ›› 2011, Vol. 38 ›› Issue (5): 461-464.

• 论著 • 上一篇    下一篇

体外受精-胚胎移植重复周期助孕结局的回顾性分析

焦雪丹, 李 予,王文军,马 芸,陈向红,杨冬梓,张清学   

  1. 510120 广州,中山大学孙逸仙纪念医院生殖中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2011-10-15 发布日期:2011-10-15
  • 通讯作者: 张清学

The Retrospective Study of the Outcomes of Repeated IVF-ET Cycles

JIAO Xue-dan，LI Yu，WANG Wen-jun，MA Yun，CHEN Xiang-hong，YANG Dong-zi，ZHANG Qing-xue   

  1. Reproductive Medical Center，Sun Yat-sen Memorial Hospital，Sun Yat-sen University，Guangzhou 510120，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-10-15 Online:2011-10-15
  • Contact: ZHANG Qing-xue

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被引次数

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摘要： 目的：研究体外受精-胚胎移植（IVF-ET）多次助孕周期妊娠结局的变化趋势，探讨影响重复周期妊娠结局的相关因素。方法：回顾性分析中山大学孙逸仙纪念医院生殖中心2008年1月—2009年10月行IVF/胞浆内单精子注射 （ICSI）助孕治疗的患者1 314例（1 746周期），其中助孕周期次数≥3的患者128例（191周期）。分析妊娠结局与助孕周期次数的关系，比较第3周期未妊娠者（A组，68例）与妊娠者（B组，37例）既往未妊娠周期中相关指标的差异。结果：临床妊娠率、活产率在第1～4周期间呈现递减趋势（P＜0.001），第1周期临床妊娠率显著高于第2周期，活产率显著高于第2～4周期，但第2周期及其后周期间临床妊娠率、活产率差异无统计学意义（P＞0.05）。 Logistic回归分析第1/2周期中有统计学意义的变量为年龄、不孕类型和优质胚胎个数，其OR值分别为0.757/0.865、12.00/3.376和1.711/1.436。结论：IVF-ET第1周期临床妊娠率和活产率高，其后周期临床妊娠率、活产率与周期次数无明显关系。在第1、2周期未妊娠的患者中，年龄越小、优质胚胎数越多和继发不孕者在第3周期中获得妊娠的可能性越大

关键词: 受精, 体外, 胚胎移植, 妊娠率, 妊娠结局, 回顾性研究

Abstract: Objective：To study the pregnancy and delivery rates of repeated IVF-ET cycles，and explore factors associated with pregnant outcome of repeated cycles. Methods：1 746 cycles of oocyte retrieval（128 repeated cycles）were retrospectively analyzed in our reproductive center from 2008.1 to 2009.10. Among the women who had no pregnancy in cycle 1 and cycle 2，there are 68 patients were still not pregnant in cycle 3（group A），and 37 patients got pregnancy in cycle 3（group B）. The factors of cycle 1 and cycle 2 were compared between group A and group B. Results：Clinical pregnancy and live-birth rates for cycle 1，2，3，4 and ≥5 were 35.5% and 34.3%，25.6% and 22.7%，23.4% and 14.0%，15.0% and 12.5%，22.7% and 15.0% respectively（P＜0.001）. The clinical pregnancy rates decreased significantly from cycle 1 to cycle 2（P＜0.05），and the live-birth rates decreased significantly from cycle 1 to cycle 2，3 and 4（P＜0.05），but there was no significant decline in clinical pregnancy and live-birth rates within cycle 2，3，4 and ≥5. It is shown in logistic model that age， primary or secondary infertility， and number of good quality embryo are significant in both cycle 1 and cycle 2. Conclusions：The outcome of the first IVF-ET cycle is better than followed cycles，but the clinical pregnancy and live-birth rates of following IVF-ET cycles were similar. Among patients who did not get pregnancy in cycle 1 and 2，younger，secondary infertility women with more good quality embryos may more likely achieve a desired outcome in cycle 3.

Key words: Fertilization in-vitro, Embryo transfer, Pregnancy rate, Pregnancy outcome, Retrospective studies