| ObjectiveTo analyze the general data and clinical data of blastocyst thawing transfer and blastocyst thawing culture to blastocyst post-transplantation,to compare the clinical pregnancy outcomes,and to provide theoretical reference for the clinical practice of assisted reproductive technology.MethodsA retrospective analysis of infertile couples who underwent cryocycle blastocyst transplantation at the Reproductive Center of Zhongshan Boai Hospital,Southern Medical University from January 2015 to December 2017 was taken as the research object.The clinical data such as their pregnancy rates,biochemical pregnancy rates and multiple pregnancy rates were analyzed.In strict accordance with the entry and exclusion criteria,a total of 1453 blastocyst transfer cycles were included.Grouped according to different treatment methods of transplanted blastocysts,in which blastocyst stage embryos were thawed and cultured to 273 cycles after blastocyst transplantation(group B),and 1180 cycles were frozen and thawed embryo transfer group(group A).The two groups were subdivided into subgroups based on the age of the woman and the number of embryos transferred.According to the age of the women,they were grouped as follows:the women were ≤30 years old and divided into the freeze-thaw blastocyst transplantation group(A1 group,n=574 cases).108 cases);30<women’s age ≤35 years old were A2 group(n=407 cases),B2 group(n=113 cases);35<women’s age ≤40 years old were A3 group(n=167 cases),B3 Group(n=44 cases);women aged>40 years were A4 group(n=32 cases)and B4 group(n=8 cases).According to the age of the woman and the number of blastocysts transplanted,the group is as follows:the woman is ≤30 years old,and one embryo is transplanted into the frozen-thawed blastocyst transfer group(A1-1 group,n=22 cases).Post-transplantation group(B1-1 group,n=23 cases);women’s age ≤30 years old,transplanted 2 embryos were divided into A1-2 group(n=520 cases),B1-2)group(n=49 cases;and so on,women’s age ≤30 The three-year-old and transplanted embryos were Al-3 group(n=32 cases)and the B1-3 group(n=36 cases);30<women’s age≤35 years old,and the transplanted one embryo were A2-1 group(n=13 cases)and B2-1 group(n=21 cases);30<women’s age ≤35 years,transplanted 2 embryos were A2-2 group(n=363 cases),B2-2 group(n=62 cases);30<woman’s age ≤35 years old,transplanted 3 embryos were divided into The A2-3 group(n=31 cases)and the B2-3 group(n=30 cases).The clinical pregnancy rate,life pregnancy rate,multiple pregnancy rate,cesarean section rate,preterm birth rate,and other clinical indicators were compared between different groups,and analyzed for the presence or absence of Statistical differences.ResultsCompared with the general data of group A and B,there were no significant differences in the indicators of male age,female BMI,infertility years,and female basic FSH(P>0.05).However,the statistical results showed that the age of the woman,the number of thawed embryos,the number of resuscitated embryos and high-quality resuscitated embryos,the number of transplanted embryos,and the thickness of the intima were statistically significant(P<0.05).The biochemical pregnancy rate and clinical pregnancy rate in group A were higher than those in group B,and the differences were statistically significant.The biochemical pregnancy rate,clinical pregnancy rate,multiple pregnancy rates in both groups,birth rate(16.3%vs 12.1%),and cesarean section There were no significant differences in the rates,full-term pregnancy rates,premature birth rates,ectopic pregnancy rates,missed abortion rates,and early and late abortion rates(P>0.05).The biochemical pregnancy rate,clinical pregnancy rate,and full-term pregnancy rate in the A1-1 group were all higher than those in the B1-1 group,and the normal and cesarean delivery rates in the A1-1 group were lower than those in the B1-1 group,and the differences were not statistically significant(P>0.05).The biochemical pregnancy rate,clinical pregnancy rate,birth rate,cesarean section rate,baby girl rate,full-term pregnancy rate,and preterm birth rate were higher in the A1-2group than in the B1-2 group.The male infant rate,missed abortion rate,early and late abortion rate,The ectopic pregnancy rate was lower than the B1-2 group,and the differences were not statistically significant(P>0.05).The biochemical pregnancy rate,clinical pregnancy rate,multiple pregnancy rate,cis birth rate,baby girl rate,and premature birth rate were higher in the A1-3 group than in the B1-3 group.Group,A1-3 group had lower cesarean section rate,baby boy rate,full-term pregnancy,missed abortion rate,early and late abortion rate,all were lower than the B1-3 group,the differences were not statistically significant(P>0.05).The multiple pregnancy rate(42.5%(110/259)vs 25%(11/44))in the A2-2 group was higher than that in the B2-2group,and the difference was statistically significant(P<0.05).There was no statistical difference in the other indicators.Conclusions1.Compared with freeze-thawed blastocyst transplantation and post-freeze-thawed embryo transfer to blastocyst transplantation,the clinical pregnancy outcomes of the two groups were statistically different,considering the relationship with the blastocyst implantation rate and the woman’s age and the number of embryos transferred;2.The number of embryos transferred is the main factor influencing the pregnancy outcome of blastocyst transfer during the freezing cycle.At the same age,as the number of transplanted blastocysts increased,the biochemical pregnancy rate and clinical pregnancy rate increased,but the multiple pregnancy rate also increased significantly;3.Single embryo and double embryo transfer can provide similar live birth rates during the freezing cycle,and the multiple pregnancy rate in single embryo transfer cases is significantly reduced. |
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