移植日注射人绒毛膜促性腺激素对冻融胚胎移植妊娠结局的影响

目的：探讨移植日注射人绒毛膜促性腺激素（human chorionic gonadotropin，hCG）是否影响冻融胚胎移植（frozen-thawed embryo transfer，FET）的妊娠结局。方法：回顾性分析第二军医大学附属长海医院生殖医学中心2015年5月—2017年8月1 636例FET周期不孕症患者临床资料，根据胚胎移植日是否注射hCG分为hCG组（1 084例）和对照组（552例），分析2组患者胚胎移植后临床妊娠结局。结果：2组患者年龄、体质量指数、不孕时间、基础卵泡刺激素水平和子宫内膜准备方案、移植日子宫内膜厚度、移植胚胎数差异均无统计学意义（P＞0.05）。2组的临床妊娠率、胚胎着床率、异位妊娠率、流产率、活产率差异均无统计学意义（P＞0.05）。根据移植胚胎期别进行卵裂期、桑葚胚期、囊胚期胚胎移植亚组分析后，2组的妊娠结局差异无统计学意义（P＞0.05）。Logistic多因素回归分析结果提示年龄、移植胚胎数以及移植优质胚胎数是影响临床妊娠的因素；而年龄是影响活产率的独立影响因素：年龄越大，活产率越低。结论：FET移植日注射hCG对妊娠结局没有显著的影响，年龄是影响妊娠结局的主要因素。

Effect of Human Chorionic Gonadotropin on the Transfer Day of Frozen-Thawed Embryo Transfer Cycles on Pregnancy Outcomes

Objective：To investigate the effect of human chorionic gonadotropin (hCG) injected on the transfer day on the pregnancy outcomes of frozen-thawed embryo transfer (FET) cycles. Methods：A total of 1636 FET cycles from May 2015 to August 2017 were analyzed retrospectively. These cycles were divided into the hCG group (1 084 cycles) and the control group (552 cycles). The pregnancy outcomes were compared between the two groups. Results：The baseline characteristics of age, body mass index, infertile duration, basic FSH level, number of embryos transferred and endometrial thickness on the transfer day were similar in the two groups (P＞0.05). There were no significant differences in the clinical pregnancy outcomes between the two groups, including the clinical pregnancy rate, embryo implantation rate, ectopic pregnancy rate, abortion rate and live birth rate(P＞0.05). The subgroup analysis, based on the transferred embryos at the cleavage stage, morula stage and blastocyst stage, found that there was no significant difference in the outcome of pregnancy(P＞0.05). Logistic multivariate regression analysis showed that age, the number of transferred embryos and transferred high-quality embryos were the factors influencing clinical pregnancy, and that age was an independent factor influencing the live birth rate. The live birth rate in those aging women was lower. Conclusions: HCG injected on the transfer day of FET cycles has no significant effect on the clinical pregnancy outcomes. Age is an important factor of the pregnancy outcomes.