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目的:探讨不同受精方式及不同胚胎移植时期是否会影响妇女异位妊娠(EP)的发生。方法:选择在本院生殖中心接受常规体外受精-移植(IVF-ET)或卵细胞胞质内单精子注射-移植(ICSI-ET)助孕治疗并成功妊娠患者的3 331个新鲜移植周期和2 706个冻融移植周期。新鲜移植周期中,IVF-ET周期2 546例,ICSI-ET周期785例,卵裂期胚胎移植2 220例,第5天囊胚移植1 111例;冻融移植周期中,IVF-ET周期2 080例,ICSI-ET周期626例,卵裂期胚胎移植741例,第5天或第6天囊胚移植1 965例。根据不同的受精方式及移植时间,比较各组间EP的发生情况。结果:新鲜移植妊娠周期中,2 546例IVF-ET周期EP发生36个周期(1.41%),785例ICSI-ET周期EP发生27个周期(3.44%),两组间的EP发生率比较,差异有统计学意义(P<0.01)。冻融移植妊娠周期中,2 080例IVF-ET周期EP发生21个周期(1.01%),626例ICSI-ET周期EP发生5个周期(0.80%),两组间的EP发生率比较,差异无统计学意义(P>0.05)。IVF-ET和ICSI-ET周期中,新鲜D3移植组(F-D3)、新鲜D5移植组(F-D5)、冻融D3移植组(T-D3)及冻融D5/6移植组(T-D5/6)各占2 220例、1 111例、741例、1 965例,EP发生例数分别为38例、25例、10例、16例,EP发生率分别为1.71%、2.25%、1.35%、0.81%,T-D5/6组EP发生率显著低于其他组(0.81%vs 1.71%,2.25%,1.35%,P<0.05)。结论:不同的受精方式可能会影响EP发生率,冻融周期囊胚移植EP的发生率显著低于新鲜周期胚胎移植和冻融周期卵裂期胚胎移植。
Objective: To investigate whether different fertilization methods and different embryo transfer stages affect the occurrence of ectopic pregnancy (EP) in women. METHODS: A total of 3 331 fresh transplantation cycles and 2 normal pregnant women receiving IVF-ET or ICSI-ET assisted pregnancy were selected in our reproductive center. 706 freeze-thaw cycles. There were 2 546 cases of IVF-ET cycle, 785 cases of ICSI-ET cycle, 2207 cases of cleavage stage embryo transfer and 1 111 cases of blastocyst transplantation on the 5th day in the fresh transplantation cycle. IVF-ET cycle 2 080 cases, 626 cases of ICSI-ET cycle, 741 cases of cleavage stage embryo transfer, and 1 965 cases of blastocyst transplantation on the 5th or 6th day. According to different methods of fertilization and transplantation time, compare the occurrence of EP between groups. Results: In the fresh grafting pregnancy cycle, there were 36 cycles (1.41%) of 2 546 cases of IVF-ET cycle and 27 cycles (3.44%) of 785 cases of ICSI-ET cycle. The difference was statistically significant (P <0.01). Among the 2 080 IVF-ET cycles, there were 21 cycles (1.01%) in the 2 080 cycles of pregnancy and 5 cycles (0.80%) of 626 ICSI-ET cycles. The difference in the incidence of EP between the 2 groups No statistical significance (P> 0.05). In fresh-donor D3 (F-D3), fresh D5 (F-D5), freeze-thaw D3 (T-D3) and freeze-thawed D5 / 6 There were 2 220 cases, 1 111 cases, 741 cases, and 1 965 cases respectively. The incidences of EP were 38 cases, 25 cases, 10 cases and 16 cases. The incidences of EP were 1.71% and 2.25% , 1.35%, 0.81%. The incidence of EP in T-D5 / 6 group was significantly lower than that in other groups (0.81% vs 1.71%, 2.25%, 1.35%, P <0.05). Conclusion: Different fertilization methods may affect the incidence of EP. The incidence of EP in frozen-thawed cycle blastocyst transplantation is significantly lower than that of fresh cycle embryo transfer and freeze-thaw cycle cleavage embryo transfer.