CAJ | 학술논문

目的：探讨影响采用人工周期准备内膜冻融胚胎移植（ frozen embryo transfer, FET)妊娠结局的相关因素,以期为临床提高FET妊娠率提供一定的指导。方法回顾分析武汉大学人民医院生殖中心2011年1月—2014年12月按人工周期准备内膜行FET的930例的临床资料,受精方式包括体外受精（ IVF )和卵胞浆内单精子注射（ ICSI),采用阴道B超监测内膜厚度,记录人工周期准备内膜行冻融胚胎移植的不孕妇女决定移植日血清雌二醇（ E2)、孕酮（ P)水平,并计算E2/P比值,分析不孕原因、不孕年限、年龄、促排卵用药方案、受精方式、内膜厚度、优质胚胎数、E2、P及E2/P等与FET临床妊娠结局的关系,并进一步采用多因素logistic回归模型分析影响妊娠结局的相关因素。结果不孕年限、年龄、子宫内膜厚度、P水平、E2/P及优质胚胎数与临床妊娠结局有一定相关性（ P<0．05, P<0．01)；logistic回归分析显示,年龄、子宫内膜厚度、E2/P为临床妊娠结局的影响因素（P<0．05,P<0．01)。结论对采用人工周期准备内膜行FET的患者重点调控子宫内膜厚度、E2/P可提高临床妊娠率；筛选适龄患者亦是提高妊娠率的重要手段。
목적：탐토영향채용인공주기준비내막동융배태이식（ frozen embryo transfer, FET)임신결국적상관인소,이기위림상제고FET임신솔제공일정적지도。방법회고분석무한대학인민의원생식중심2011년1월—2014년12월안인공주기준비내막행FET적930례적림상자료,수정방식포괄체외수정（ IVF )화란포장내단정자주사（ ICSI),채용음도B초감측내막후도,기록인공주기준비내막행동융배태이식적불잉부녀결정이식일혈청자이순（ E2)、잉동（ P)수평,병계산E2/P비치,분석불잉원인、불잉년한、년령、촉배란용약방안、수정방식、내막후도、우질배태수、E2、P급E2/P등여FET림상임신결국적관계,병진일보채용다인소logistic회귀모형분석영향임신결국적상관인소。결과불잉년한、년령、자궁내막후도、P수평、E2/P급우질배태수여림상임신결국유일정상관성（ P<0．05, P<0．01)；logistic회귀분석현시,년령、자궁내막후도、E2/P위림상임신결국적영향인소（P<0．05,P<0．01)。결론대채용인공주기준비내막행FET적환자중점조공자궁내막후도、E2/P가제고림상임신솔；사선괄령환자역시제고임신솔적중요수단。
Objective To explore the influencing factors of the pregnancy outcome of the frozen embryo transfer in ar-tificial cycles. Methods A retrospective analysis was performed for clinical data of 930 cases undergoing frozen embryo trans-fer treatment during Jan. 2011 and Dec. 2014. All patients accepted hormone replacement therapy. Endometrial thickness was monitored by transvaginal ultrasound. Estrogen ( E2 ) and progesterone ( P) level as well as E2/P ratio were recorded. Infertil-ity factors, time, age, ovulation induction regimen, insemination, endometrial thickness, E2 level, P level and E2/P ratio and their relation with the clinical pregnancy outcomes were analyzed. In addition, the multivariate Logistic Regression model was used to investigate the related factors affecting pregnancy outcome FET. Results Infertility time, age, endometrial thickness, P level, E2/P ratio and good quality embryo had a relationship with clinical pregnancy outcomes(P<0. 05,P<0. 01). Multi-variate logistic regression analysis showed that age, endometrial thickness and E2/P ratio could affect clinical pregnancy out-comes(P<0. 05,P<0. 01). Conclusion Regulating endometrial thickness, E2/ P ratio factors can improve clinical preg-nancy rate for patients undergoing FET in artificial cycle. Screening patients of suitable age is also an important means to im-prove the pregnancy rate.