| Objective: The objection is to discuss its impaction on the embryo implantation rate, clinical pregnancy rate and abortion rate through comprehensivly analyzing multi-factors of implementing frozen-thawed embryo transfer patients, such as the patients'age, endometrial thickness and form, the number, quality and timing of embryos transferred.Methods: A retrospective study of 472 frozen-thawed embryo transfer cycles from May. 2007 to Dec. 2009 in the Second Hospital of HeBei Medical University was performed. 1, The range of female age was 21 to 40 year, We divided it into three groups (≤30y group,31~35y group,>35y group). 2, The range of infertile duration was 1 to 15 year, We divided it into three groups(<5years group,5~10years group,>10years group). 3, The fertilization methods were IVF group and ICSI group. 4, There have four methods for preparing endometrial: nature cycle, LUFS, HRT, HMG. 5, We divided four groups according to the endometrial thickness (≤8mm group, 9~12mm group,≥13mm group). 6, We divided three groups according to the endometrial pattern (pattern A, pattern B, pattern C). 7, We divided three groups according to Serum LH level(<50mIU/Ml group, 50~80 mIU/Ml group, >80 mIU/Ml group). 8, We divided four groups according to Serum E2 level(<200pg/ml group,200~400pg/ml group,401~600 pg/ml group,>600 pg/ml group)9,We divided three groups according to the number of transferred embryos(1 embryo,2 embryos,3 embryos). 10, We divided four groups according to the number of transferred good quality embryos per cycle (ET0 good quality embryo group, ET1 good quality embryo group, ET2 good quality embryo group, ET3 good quality embryo group).Conclusion:Among the 1228 thawed embryos from 472 frozen- thawed embryo transfer cycles, the transferred embryos per cycle on average are 2.4±0.7. The number of embryo implantation is 228. Among the 472 frozen- thawed embryo transfer cycles, there were 173 cycles pregnant; 54 cycles got multiple pregnancies; 44 cycles got abortion; 3 cycles were ectopic pregnancy. The embryo implantation rate was 19.11%. The clinical pregnancy rate was 36.65%. The abortion rate was 25.43%. The multiple gestation rate was 31.21%. The ectopic pregnancy rate was 1.73%.1 The age factor: Frozen-thawed embryo implantation rate of >35y group was significantly lower than the former two groups(P<0.05).Comparison of clinical pregnancy rate and abortion rate,there was no significant difference in these three groups(P>0.05).2 The factor of infertile duration: Frozen-thawed embryo abortion rate of >10y group was significantly higher than the former two groups(P<0.05). Comparison of frozen-thawed embryo clinical pregnancy rate and abortion rate,there was no significant difference in these three groups(P>0.05).3 The fertilization methods factor: Comparison of frozen-thawed embryo implantation rate, clinical pregnancy rate and abortion rate,there was no significant difference between IVF group and ICSI group(P>0.05).4 Four methods of preparing endometrial factor: The abortion rate of ovulation induction (HMG) cycle was 0; there was no significant difference in the other three groups(P>0.05). Comparison of embryo implantation rate and clinical pregnancy rate, hormone substitution cycles was significantly higher than the other three groups(P<0.05)5 The endometrial thickness factor: Comparison of embryo implantation rate, 9~12mm group was significantly higher than the other two groups(P<0.05); Frozen-thawed embryo Clinical pregnancy rate and abortion rate among the three groups were no significant difference(P>0.05).6 The endometrial pattern factor: Comparison of frozen-thawed embryo clinical pregnancy rate and abortion rate,there was no significant difference in these three groups(P>0.05).7 Luteotropic hormone level of the day before ovulation factor: Comparison of frozen-thawed embryo implantation rate, clinical pregnancy rate and abortion rate,there was no significant difference in these four groups(P>0.05).8 Serum E2 level factor: Comparison of frozen-thawed embryo implantation rate, clinical pregnancy rate and abortion rate,there was no significant difference in these four groups(P>0.05).9 The number of transferred embryos per cycle factor: Frozen-thawed embryo implantation rate of 2 embryos was significantly higher than the other two groups(P<0.05). Clinical pregnancy rate of 1embryo was significantly lower than the later two groups(P<0.05). Comparison of abortion rate, there was no significant difference in these three groups(P>0.05).10 The number of transferred good-quality embryos per cycle factor: The frozen-thawed embryo implantation rate of ET0 good quality embryo group was 0, and had no clinical pregnancy. Comparing with the frozen-thawed embryo implantation rate, ET3 good quality embryo group was significantly higher than the other 2 groups(P<0.05). Comparison of clinical pregnancy rate and abortion rate, there was no significant difference in these three groups(P>0.05).Logistics regression analysis of clinical pregnancy-associated factors showed that:The age of female partners ,the method of endometrial preparation ,the number and quality of transffed embryos per cycle, were significantly correlated to clinical pregnancy(P>0.05). Infertile duration, fertilization methods, endometrial thickness and pattern, luteotropic hormone level and serum E2 levels was no significant correlation with clinical pregnancy(P>0.05).Conclusion:1 Among the tested factors,The age of female partners , infertile duration ,the number of transferred embryos and good embryos, endometrial preparation has significant effect on the cryopreservation human embryo implantation.2 Fertilization methods, endometrial thickness and pattern, luteotropic hormone level and serum E2 levels was no significant correlation with cryopreservation human embryo implantation.3 May be hormone substitution cycles is a better method of endometrial Preparation,further studies are still needed. |
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