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目的分析比较在体外受精胚胎移植治疗过程中存在卵巢过度刺激综合征(OHSS)高危因素患者行单胚胎移植与双胚胎移植的临床妊娠结局,为推广单胚胎移植降低医源性并发症提供依据。方法回顾性分析2008年1月-2011年4月在湖南省妇幼保健院接受体外受精胚胎移植治疗的具有卵巢过度刺激综合征高危因素的患者122例,单胚胎移植41例(A组)和双胚胎移植81例(B组),比较两组患者绒毛膜促性腺激素(HCG)注射日子宫内膜(Em)厚度和血清雌二醇(E2)值、获卵数、临床妊娠率、双胎发生率、中重度OHSS发生率。结果单胚胎移植组HCG注射日的Em厚度及E2值、获卵数、临床妊娠率与对照组相比差异无统计学意义(P>0.05),单胚胎移植组的双胎发生率、中重度OHSS发生率与对照组相比差异有统计学意义(P<0.05)。结论在体外受精胚胎移植治疗过程中具有OHSS高危因素的不孕患者选择优质单胚胎移植不影响其妊娠率,但可显著降低双胎妊娠率及中重度OHSS发生率。
Objective To analyze and compare the clinical pregnancy outcomes of single embryo transfer and double embryo transfer in the process of in vitro fertilization embryo transfer in patients with high risk of ovarian hyperstimulation syndrome (OHSS), and to provide basis for the promotion of single embryo transfer to reduce iatrogenic complications. Methods A total of 122 patients with high risk of ovarian hyperstimulation syndrome who underwent IVF embryo transfer from January 2008 to April 2011 in Hunan MCH hospital were retrospectively analyzed. A single embryo transfer was performed in 41 patients (group A) and double (B group). The thickness of endometrial (Em) and serum estradiol (E2) on the day of HCG injection were compared between the two groups. The number of oocytes retrieved, the rate of clinical pregnancy, twin Incidence, the incidence of moderate and severe OHSS. Results There were no significant differences in Em thickness, E2 value, number of oocytes retrieved and clinical pregnancy rate between HCG injection and single embryo transplantation groups (P> 0.05), the incidence of twins in single embryo transfer group, OHSS incidence compared with the control group, the difference was statistically significant (P <0.05). Conclusions The selection of high quality single embryo transfer in infertile patients with high risk of OHSS during in vitro fertilization embryo transfer does not affect the pregnancy rate, but can significantly reduce the twin pregnancy rate and the incidence of moderate and severe OHSS.