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Embryo retention significantly decreases clinical pregnancy rate and live birth rate: a matched retrospective cohort study
Fertility and Sterility ( IF 6.6 ) Pub Date : 2020-10-01 , DOI: 10.1016/j.fertnstert.2020.04.043
Jian Xu 1 , Min-Na Yin 1 , Zhi-Heng Chen 1 , Li Yang 1 , De-Sheng Ye 1 , Ling Sun 1
Affiliation  

OBJECTIVE To investigate the embryo retention (ER) rate in embryo transfer (ET) cycles and its effects on reproductive outcomes. DESIGN Matched retrospective cohort study. SETTING A tertiary hospital-based reproductive medicine center. PATIENT(S) A total of 6,089 ET cycles were performed from January 2013 to December 2018 in our unit. INTERVENTION(S) Each woman was matched with two separate control subjects of the same age (±1 year), embryo condition, main causes of infertility, type of protocol used for fresh or frozen ET cycles. MAIN OUTCOME MEASURE(S) ER rate, implantation, clinical pregnancy, ectopic pregnancy, and live birth rate. RESULTS The overall incidence of ER was 1.59% (97/6,089). A significantly increased ER rate was observed in fresh ET cycles compared with frozen transfer cycles (2.71% vs. 1.08%). In fresh transfer cycles, the rate of mucus in or on the catheter after ET in ER group was significantly higher than in the non-ER group (48.09% vs. 13.65%). A total of 194 non-ER cycles were matched to the ER group. Compared with the matched group, the ER group was associated with a significantly lower clinical pregnancy rate (32.98% vs. 48.96%), implantation rate (20.88% vs. 35.97%), and live birth rate (22.68% vs. 37.63%, P<.01), and a higher ectopic pregnancy rate (12.50% vs. 3.16%). CONCLUSION Our results suggest that ER rate is correlated with mucus on or in the transfer catheter in fresh transfer cycles. Retained embryos are associated with lower implantation, clinical pregnancy, live birth, and increases risk of ectopic pregnancy.

中文翻译:

胚胎保留显着降低临床妊娠率和活产率:一项匹配的回顾性队列研究

目的 研究胚胎移植 (ET) 周期中的胚胎保留 (ER) 率及其对生殖结果的影响。设计 匹配回顾性队列研究。设置以三级医院为基础的生殖医学中心。患者从 2013 年 1 月到 2018 年 12 月,我们单位共进行了 6,089 次 ET 周期。干预(S) 每名妇女与两个相同年龄(±1 岁)、胚胎状况、不孕的主要原因、用于新鲜或冷冻 ET 周期的协议类型的独立对照受试者相匹配。主要结局指标 ER 率、着床率、临床妊娠、异位妊娠和活产率。结果 ER 的总体发生率为 1.59% (97/6,089)。与冷冻转移周期相比,在新鲜 ET 周期中观察到 ER 率显着增加(2.71% 对 1.08%)。在新的转移周期中,ER 组 ET 后导管内或导管上的粘液率显着高于非 ER 组(48.09% vs. 13.65%)。共有 194 个非 ER 周期与 ER 组匹配。与匹配组相比,ER组的临床妊娠率(32.98% vs. 48.96%)、着床率(20.88% vs. 35.97%)和活产率(22.68% vs. 37.63%, P<.01),以及更高的异位妊娠率(12.50% 对 3.16%)。结论 我们的结果表明 ER 率与新鲜转移周期中转移导管上或转移导管中的粘液相关。保留的胚胎与较低的着床率、临床妊娠率、活产率有关,并增加了异位妊娠的风险。共有 194 个非 ER 周期与 ER 组匹配。与匹配组相比,ER组的临床妊娠率(32.98% vs. 48.96%)、着床率(20.88% vs. 35.97%)和活产率(22.68% vs. 37.63%, P<.01),以及更高的异位妊娠率(12.50% 对 3.16%)。结论 我们的结果表明 ER 率与新鲜转移周期中转移导管上或转移导管中的粘液相关。保留的胚胎与较低的着床率、临床妊娠率、活产率有关,并会增加异位妊娠的风险。共有 194 个非 ER 周期与 ER 组匹配。与匹配组相比,ER组的临床妊娠率(32.98% vs. 48.96%)、着床率(20.88% vs. 35.97%)和活产率(22.68% vs. 37.63%, P<.01),以及更高的异位妊娠率(12.50% 对 3.16%)。结论 我们的结果表明 ER 率与新鲜转移周期中转移导管上或转移导管中的粘液相关。保留的胚胎与较低的着床率、临床妊娠率、活产率有关,并增加了异位妊娠的风险。01),以及更高的异位妊娠率(12.50% vs. 3.16%)。结论 我们的结果表明 ER 率与新鲜转移周期中转移导管上或转移导管中的粘液相关。保留的胚胎与较低的着床率、临床妊娠率、活产率有关,并会增加异位妊娠的风险。01),以及更高的异位妊娠率(12.50% vs. 3.16%)。结论 我们的结果表明 ER 率与新鲜转移周期中转移导管上或转移导管中的粘液相关。保留的胚胎与较低的着床率、临床妊娠率、活产率有关,并会增加异位妊娠的风险。
更新日期:2020-10-01
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