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。
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 multicentre, randomized trial to evaluate its effectiveness and side effects, although it has the positive clinical application for other reasons of cryopreservation of all embryos.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2013年第6期882-886,共5页
Journal of Peking University:Health Sciences
基金
国家自然科学基金(81000234
81070534)资助~~
关键词
胚胎处置
低温保存
受精
体外
胚胎移植
治疗结果
Embryo disposition, Cryopreservation, Fertilization in vitro, Embryo transfer, Treatment outcome
