Reproductive BioMedicine Online ( IF 4 ) Pub Date : 2020-08-18 , DOI: 10.1016/j.rbmo.2020.08.009 Mathilde Bourdon 1 , Pietro Santulli 1 , Lauren Sebbag 2 , Chloé Maignien 2 , Francois Goffinet 3 , Louis Marcellin 1 , Charles Chapron 1
Research question
What are the perinatal outcomes and especially the risk of small for gestational age (SGA) babies born after frozen versus fresh embryo transfer in mothers affected by endometriosis undergoing treatment with assisted reproductive technology (ART)?
Design
A cohort study conducted between November 2012 and October 2017, in which infertile women with endometriosis undergoing ART and achieving singleton pregnancies that lasted beyond 12 weeks of gestation were included. Pregnancies obtained after a frozen embryo transfer (FET) were compared with those obtained after a fresh embryo transfer. A total of 339 pregnant women were included: 112 patients in the fresh embryo transfer group and 227 in the FET group. The main outcome was the rate of SGA. Secondary analyses were performed for adverse pregnancy outcomes and perinatal complications.
Results
Of the included women, 109/112 (97.3%) and 222/227 (97.8%) delivered a live child after at least 24 weeks of gestation in the fresh and in the frozen embryo transfer groups, respectively (P = 0.53). The risk of SGA decreased after a FET compared with a fresh embryo transfer (odds ratio [OR] 0.49 [0.25–0.98], P = 0.04) after multivariable analysis. The mean birthweight and the gestational age at delivery were not significantly different between the two study groups. Other pregnancy and perinatal complications were not statistically different between the two study populations.
Conclusions
The present study of endometriosis-affected women found a significantly lower risk of SGA in patients undergoing frozen, mainly blastocyst, embryo transfer compared with patients undergoing fresh, mainly cleavage stage, embryo transfer.
中文翻译:
与新鲜胚胎移植相比,子宫内膜异位症冷冻后小于胎龄的风险降低
研究问题
在接受辅助生殖技术 (ART) 治疗的受子宫内膜异位症影响的母亲中,围产期结局是什么,尤其是在冷冻胚胎与新鲜胚胎移植后出生的小于胎龄 (SGA) 婴儿的风险是什么?
设计
一项队列研究于 2012 年 11 月至 2017 年 10 月期间进行,其中包括接受 ART 且单胎妊娠超过 12 周的不孕不育女性。将冷冻胚胎移植 (FET) 后获得的妊娠与新鲜胚胎移植后获得的妊娠进行比较。共纳入 339 名孕妇:新鲜胚胎移植组 112 例,FET 组 227 例。主要结果是 SGA 的发生率。对不良妊娠结局和围产期并发症进行二次分析。
结果
在纳入的女性中,新鲜胚胎移植组和冷冻胚胎移植组分别有 109/112 (97.3%) 和 222/227 (97.8%) 在妊娠至少 24 周后分娩了活孩子 ( P = 0.53)。 多变量分析后,与新鲜胚胎移植相比,FET 后 SGA 的风险降低(优势比 [OR] 0.49 [0.25–0.98],P = 0.04)。两个研究组的平均出生体重和分娩时的胎龄没有显着差异。两个研究人群之间的其他妊娠和围产期并发症没有统计学差异。
结论
目前对受子宫内膜异位症影响的女性的研究发现,与接受新鲜(主要是卵裂期)胚胎移植的患者相比,接受冷冻(主要是囊胚)胚胎移植的患者发生 SGA 的风险显着降低。