冷胚胎转移的科学,是修改自然循环更好吗?
Hassan Hamze1, Wadad Alameh2, Robert Hemmings1
1Université de Montréal- Clinique OVO, Montreal, Quebec, Canada.
概括
与人工周期相比,在修改自然周期 (m-NC) 中的冷胚胎移植导致更高的活产率和更低的流产率. 虽然m-NC需要更多的访问,但它为接受试管婴儿的妇女提供了更好的怀孕结果.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精过程中受精.
- 产科和妇科 产科和妇科
背景情况:
- 冷胚胎移植 (FET) 是辅助生殖技术的一个关键组成部分.
- 选择FET的最佳子宫内膜制备方案对于成功的植入和怀孕至关重要.
- 人工循环 (AC) 和修改自然循环 (m-NC) 是FET的两个常见协议.
研究的目的:
- 为了比较人工与修改的自然周期中的FET之间的怀孕和产科结果.
- 评估每个协议所需的访问次数.
- 评估与FET协议相关的活产率和流产率.
主要方法:
- 在2022年对1207个FET周期的回顾性研究.
- 排除40岁以上的患者,有反复的植入失败或反复的怀孕流产.
- 649个病例的划分包括患者在AC和m-NC组中,根据协议类型,年龄,BMI和AMH.
- 超声监测m-NC与hCG触发;雌激素和孕激素补充AC.
主要成果:
- 在AC组中,初始阳性B-hCG较高.
- 在m-NC组中显著改善临床怀孕和活产率.
- 与m-NC相比,AC组的流产率显著更高.
- 两组之间平均子宫内膜厚度没有显著差异.
- 在m-NC集团中访问次数较多.
- 在m-NC中,妊娠高血压障碍 (HDP) 的风险较低,但妊娠糖尿病的风险不显著增加.
结论:
- 在修改后的自然周期中,FET产生了更高的活产率和更低的流产率.
- 修改后的自然循环需要更频繁的诊所访问.
- 虽然AC可能会显示出更高的初始阳性妊娠测试,但m-NC似乎对持续的妊娠结果优越,特别是在减少流产率方面.
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