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用于排卵女性的新鲜和冷冻胚胎移植的比较
Transfer of Fresh versus Frozen Embryos in Ovulatory Women


Yuhua Shi ... 围产医学和儿科 • 2018.01.11
相关阅读
• 冷冻全部胚胎会成为体外受精的决胜武器吗 • 新鲜或冷冻胚胎用于治疗多囊卵巢综合征不孕症的比较

对于排卵功能正常的不孕患者,移植冷冻还是新鲜胚胎效果更好

 

郑丹妮,龙晓宇,乔杰*

国家妇产科疾病临床医学研究中心;教育部辅助生殖重点实验室;北京大学第三医院生殖医学中心

*通讯作者

 

自1978年世界第一例“试管婴儿”在英国诞生,以及1988年中国内地第一例“试管婴儿”于北京大学第三医院诞生以来,国内外辅助生殖技术(assisted reproductive technology,ART)在近40年内发展迅速。如今,在工业化国家中,每年1%~3%的新生儿是通过ART出生的1,且全世界借助体外受精(in vitro fertilization,IVF)技术出生的新生儿已超过500万2

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摘要


背景

已有研究显示在患多囊卵巢综合征的无排卵女性中,选择性冷冻胚胎移植的活产率高于新鲜胚胎移植。尚不确定冷冻胚胎移植是否可提高患不孕症的排卵女性的活产率。

 

方法

在这项多中心的随机试验中,我们将2,157名进行第一次体外受精周期的女性随机分配进行新鲜胚胎移植,或胚胎冷冻保存后进行冷冻胚胎移植。每名参与者最多移植两个卵裂期胚胎。主要结局是在第一次胚胎移植后活产。

 

结果

冷冻胚胎组和新鲜胚胎组的活产率无显著差异(分别为48.7%和50.2%;相对风险,0.97;95%置信区间[CI],0.89~1.06;P=0.50)。植入率、临床妊娠率、总体妊娠丢失率和持续妊娠率也无显著组间差异。冷冻胚胎移植导致的卵巢过度刺激综合征风险显著低于新鲜胚胎移植(0.6% vs. 2.0%;相对风险,0.32;95% CI,0.14~0.74;P=0.005)。产科和新生儿并发症及其他不良结局的风险在两组之间无显著差异。

 

结论

在患不孕症的排卵女性中,新鲜胚胎移植和冷冻胚胎移植的活产率无显著差异,但是冷冻胚胎移植导致的卵巢过度刺激综合征风险较低(由中国国家重点研发计划和中国国家自然科学基金委员会资助;中国临床试验注册中心的注册号为ChiCTR-IOR-14005406)。





作者信息

Yuhua Shi, M.D., Ph.D., Yun Sun, M.D., Ph.D., Cuifang Hao, M.D., Ph.D., Heping Zhang, Ph.D., Daimin Wei, M.D., Ph.D., Yunshan Zhang, M.D., Yimin Zhu, M.D., Ph.D., Xiaohui Deng, M.D., Xiujuan Qi, M.D., Hong Li, M.D., Xiang Ma, M.D., Ph.D., Haiqin Ren, M.D., Yaqin Wang, M.D., Ph.D., Dan Zhang, M.D., Ph.D., Bo Wang, M.S., Fenghua Liu, M.D., Qiongfang Wu, M.D., Ze Wang, M.S., Haiyan Bai, Ph.D., Yuan Li, M.D., Ph.D., Yi Zhou, M.D., Mei Sun, M.D., Ph.D., Hong Liu, M.D., Ph.D., Jing Li, M.S., Lin Zhang, M.S., Xiaoli Chen, M.D., Ph.D., Songying Zhang, M.D., Ph.D., Xiaoxi Sun, M.D., Ph.D., Richard S. Legro, M.D., and Zi-Jiang Chen, M.D., Ph.D.
From the Center for Reproductive Medicine, Shandong Provincial Hospital–Shandong University, the Key Laboratory of Reproductive Endocrinology of Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics (Y. Shi, D.W., Z.W., M.S. H. Liu, J.L., L.Z., Z.-J.C.), and the Center for Reproductive Medicine, Qilu Hospital of Shandong University (X.D.), Jinan, the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, and Shanghai Key Laboratory of Assisted Reproduction and Reproductive Genetics (Y. Sun, Z.-J.C.), and the Shanghai Jiai Genetic and IVF Center, Obstetrics and Gynecology Hospital, Fudan University (X.S.), Shanghai, the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin (Y. Zhang), the Department of Reproductive Endocrinology, Women’s Hospital (Y. Zhu, D.Z.), and the Center for Reproductive Medicine (S.Z.), School of Medicine, Zhejiang University, Hangzhou, the Affiliated Hospital of Qingdao University (X.Q.) and the Center for Reproductive Medicine, Qingdao Women and Children’s Hospital–Qingdao University (Y. Zhou), Qingdao, the Center for Reproduction and Genetics, Suzhou Municipal Hospital, Suzhou (H. Li), the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University–Jiangsu Province Hospital, Nanjing, (X.M.), the Reproductive Medicine Center of Jinghua Hospital, Shenyang (H.R.), the Center for Reproductive Medicine, Wuhan University, Wuhan (Y.W.), the Reproductive Medicine Research Center, 6th Affiliated Hospital of Sun Yat-sen University (B.W.), the Center for Reproductive Medicine, Women and Children’s Hospital of Guangdong Province (F.L.), and the Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University (X.C.), Guangzhou, the Center for Reproductive Medicine, Maternal and Child Health Care Hospital of Jiangxi Province, Nanchang (Q.W.), the Center for Assisted Reproduction, Northwest Women and Children’s Hospital, Xi’an (H.B.), and the Center for Reproductive Medicine, Beijing Chaoyang Hospital, Beijing (Y.L.) — all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.). Address reprint requests to Dr. Z.-J. Chen at the Center for Reproductive Medicine, Shandong Provincial Hospital–Shandong University, 324 Jingwu Rd., Jinan, 250021, China, or at chenzijiang@hotmail.com.

 

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