【摘要】 目的 探讨不同年龄段和不同内膜准备方法对冻融胚胎移植（FET）妊娠率的影响。 方法 回顾性分析2007年3月-2009年8月107例患者131个FET周期，比较不同年龄段、不同内膜准备方法的妊娠情况。 结果 ①lt;29岁、30～34岁、≥35岁患者的周期临床妊娠率分别为45.28%、37.88%、33.33%，比较无统计学意义（Pgt;0.05）。②自然周期和激素替代周期内膜准备，两种方法患者平均年龄、平均移植胚胎数、胚胎评分及胚胎细胞数比较无统计学意义（Pgt;0.05），但自然周期的胚胎种植率及周期临床妊娠率均明显低于激素替代周期（16.78%比29.21%；29.51%比50.00%），比较有统计学意义（Plt;0.05）。 结论 患者年龄不影响FET周期临床妊娠率，激素替代周期内膜准备的FET胚胎种植率及周期临床妊娠率明显高于自然周期。【Abstract】 Objective To analyze the effect of age and method of preparing endometrium on the pregnancy rate of frozen-thawed embryo transfer (FET) among infertile women. Methods Retrospective analysis was made on 131 FET cycles in 107 patients from March 2007 to August 2009. The relationship between pregnancy rate of FET and following factors were analyzed: age, the method of preparing uterus endometrium. Results ①There was no significant difference in pregnancy rate of FET among ＜29, 30 - 34, and ≥35 years old patients (45.28%, 37.88%, and 33.33%, respectively) (Pgt;0.05). ②There was no significant difference in patients’ age, the average embryo amount, embryo score, the cell amount in every embryo between the FET with hormone replacement therapy (HRT) and the FET with natural cycle (NC). The embryo implantation rate and pregnancy rate of FET with NC were lower significantly than those of FET with HRT (16.78% vs 29.21%; 29.51% vs 50.00%) (P＜0.05). Conclusion Age might not influence pregnancy rate of FET. FET with HRT has higher implantation rate and pregnancy rate than FET with NC.
ObjectivesTo systematically review the efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure in vitro fertilization.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect clinical controlled studies on the efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure from inception to March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 10 studies, including 8 randomized controlled trials and 2 case-control studies, and involving 1 274 patients were included. The results of meta-analysis showed that: the clinical pregnancy rate of endometrial mechanical stimulation group was higher than that of control group (RR=1.40, 95%CI 1.04 to 1.89, P=0.03). However, no significant differences were found in implantation rate (RR=0.75, 95%CI 0.50 to 1.13, P=0.17), live births rate (RR=1.38, 95%CI 0.99 to 1.93, P=0.06), miscarriage rate (RR=0.83, 95%CI 0.55 to 1.24, P=0.36) and rate of multiple pregnancy (RR=0.90, 95%CI 0.61 to 1.35, P=0.63).ConclusionCurrent evidence shows that, for patients with repeated implantation failure, mechanical endometrial stimulation before re-transplantation may help to improve the clinical pregnancy rate of test-tube infants, however, it has no significant effects on implantation rate, live birth rate, abortion rate, multiple pregnancy rate and ectopic pregnancy rate. Due to limited quality and quantity of the included studies, more high quality studies are needed required to verify above conclusions.
Objective To analyze the efficacy and safety of different acupuncture methods on outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods The PubMed, EMbase, Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were searched to collect randomized controlled trials (RCTs) related to the objectives of the study from the inception to April 16, 2023. After two investigators independently screened the literature, extracted the data and evaluated the risk of bias of the included studies, a network meta-analysis was performed using Stata 16.0 software. Results There were 62 trials total with 9844 patients, involving 7 interventions. Network meta-findings analysis revealed the following: ① Clinical pregnancy rate (CPR): needle warming > auricular acupressure > transcutaneous electrical acupoint stimulation (TEAS) > electroacupuncture > acupuncture > sham acupuncture > no adjunctive treatment; ② Live birth rate (LBR): electroacupuncture > auricular acupressure > TEAS > acupuncture > sham acupuncture > no adjunctive treatment. Conclusion Needle warming assisted IVF-ET is superior to other acupuncture therapies in improving CPR, especially during the promotion period of excretion, and the selection of Zusanli, Guanyuan and uterine acupoints for 3-month cycles may have the best effect. And for the LBR, the effect of electroacupuncture is better than that of other therapies. Besides, auricular acupressure may have good therapeutic potential. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.