Singleton pregnancy outcomes in frozen-thawed embryo transfer in natural cycle and hormone replacement therapy cycle：a comparative study

doi:10.12114/j.issn.1007-9572.2020.00.097

Abstract

Abstract: Background　Frozen-thawed embryo transfer（FET） has been popularized in assisted reproductive technology（ART）.The natural cycle or hormone replacement therapy cycle is important in FET，whose safety has gained increased attention.Objective　To perform a comparative study of singleton pregnancy outcomes following frozen-thawed embryo transfer in natural cycle and hormone replacement therapy cycle.Methods　This retrospective study was conducted in a cohort of 419 cases with single live birth following successful FET from Reproductive Medicine Centre，the First Affiliated Hospital of Xinjiang Medical University during January 2013 to June 2017.According to the method of endometrial preparation，they were divided into group A（n=175，natural cycle），and group B（n=244，hormone replacement therapy cycle）.General data of two groups were collected，including the age of the couple，maternal BMI，years of infertility，levels of basal FSH，basal luteinizing hormone（LH），anti-Mullerian hormone（AMH），total dose and administration duration of gonadotropins for superovulation cycle，estrogen level on the day of injecting HCG，number of retrieved oocytes，number of oocytes arrested at metaphase of meiosis Ⅱ（MⅡ），number of 2-pronuclear（2PN） zygotes，endometrial thickness on the day of FET，and number of embryos transferred.A follow-up was given to both groups for collecting data about prevalence rates of normal-birth-weight and low-birth-weight infants，preterm infants，preterm and full-term low-birth-weight infants，and macrosomia，sex ratio of newborn birth weight，and gestational age at delivery.Results The number of total natural cycles of group A was 175，and that of hormone replacement therapy cycles for group B was 244.Two groups showed no significant differences in general data （P>0.05）.Compared with group A，group B showed a lower prevalence rate of normal-birth-weight infants（P<0.05）.But two groups showed similar prevalence rates of preterm infants，low-birth-weight infants，preterm and full-term low-birth-weight infants，macrosomia，and male infants，as well as similar mean neonatal birth weight and gestational age at delivery（P>0.05）.Conclusion　Frozen-thawed embryo transfer using endometrial preparation with natural cycle may yield a higher rate of normal-birth-weight infants，and better pregnancy outcomes.

Key words: Embryo transfer；Assisted reproductive technology；Natural cycle；Hormone replacement therapy cycle；Infant, newborn；Infant, low birth weight

摘要： 背景　冻融胚胎移植（FET）在辅助生殖技术（ART）中的应用越来越广泛，而自然周期或激素替代周期是其重要环节，二者的安全性逐渐被重视。目的　探究自然周期与激素替代周期的FET方案对单胎妊娠新生儿结局的影响。方法　回顾性收集2013年1月—2017年6月在新疆医科大学第一附属医院生殖医学中心行体外受精FET的419例单胎活产患者的临床资料。按内膜准备方案不同分为2组，A组（n=175）为自然周期FET患者，B组（n=244）为未能按时返院行排卵监测，给予激素替代周期FET患者。收集所有患者的基本资料，包括男女双方年龄、不孕年限、体质指数（BMI）、基础卵泡刺激素（FSH）、基础促黄体生成素（LH）、抗缪勒试管激素（AMH）、超促排周期的促性腺激素（Gn）总量及注射Gn的天数、人绒毛膜促性腺激素（HCG）注射日雌激素水平、获卵数、第二次减数分裂中期卵母细胞（MⅡ）数、正常受精卵（2PN）数、FET日子宫内膜厚度、移植胚胎数。随访其两组正常体质量儿发生率、早产儿发生率、低体质量儿发生率、早产低体质量儿发生率、足月低体质量儿发生率、巨大儿发生率、新生儿性别比、出生体质量、分娩孕周。结果　419例患者中，A组患者自然周期为175个周期，B组患者激素替代周期为244个周期。A组患者年龄、配偶年龄、不孕年限、BMI、基础FSH、基础LH、AMH、超促排周期的Gn总量、超促排周期的注射Gn的天数、HCG注射日雌激素水平、获卵数、MⅡ数、2PN数、FET日子宫内膜厚度、移植胚胎数比较，差异无统计学意义（P>0.05）。B组正常体质量儿发生率低于A组（P<0.05）；两组早产儿发生率、低体质量儿发生率、早产低体质量儿发生率、足月低体质量儿发生率、巨大儿发生率、新生儿男性出生率、新生儿出生体质量、分娩孕周比较，差异无统计学意义（P>0.05）。结论　相较于激素替代周期的FET患者，自然周期的FET患者正常体质量儿发生率更高，妊娠结局更好。

关键词: 胚胎移植, 辅助生殖技术, 自然周期, 激素替代周期, 婴儿, 新生, 婴儿, 出生时低体重

TIAN Haiqing,MEN Hongqin,ZHANG Meng, et al. Singleton pregnancy outcomes in frozen-thawed embryo transfer in natural cycle and hormone replacement therapy cycle：a comparative study[J]. Chinese General Practice, 2020, 23(21): 2673-2677. DOI: 10.12114/j.issn.1007-9572.2020.00.097.
田海清,门鸿芹,张萌等. 自然周期与激素替代周期的冻融胚胎移植方案对单胎妊娠新生儿结局的影响研究[J]. 中国全科医学, 2020, 23(21): 2673-2677. DOI: 10.12114/j.issn.1007-9572.2020.00.097.

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