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引用次数: 0
摘要
目的研究辅助生殖技术(ART)中无痛取卵活产的母婴结局:我们对2021年9月至2023年5月期间在江西省妇幼保健院生殖医学中心通过体外受精/卵胞浆内单精子注射和胚胎移植(IVF/ICSI-ET)获得活产的患者的临床数据进行了回顾性队列分析。研究纳入了5806个卵泡早期延长方案中的新鲜胚胎移植周期。倾向得分匹配结果显示,无痛取卵组和对照组(常规取卵组)各有 1,563 例。采用单变量分析评估基本临床数据、产妇并发症和新生儿出生结果的差异:结果:两组在取卵数量、受精方式、成熟 ICSI 卵母细胞、正常受精卵母细胞、正常裂解卵母细胞、优质胚胎、可移植胚胎、ICSI 卵母细胞成熟率、正常受精率、正常裂解率、优质胚胎率、可移植囊胚形成率、不可移植胚胎率和新鲜胚胎移植率等方面均无统计学意义(均 P > 0.05)。同样,两组在移植胚胎数量、移植胚胎类型、移植过程中至少出现一个优质胚胎、HCG 阳性率、生化流产率、胚胎植入率、临床妊娠率、流产率、活产率、单胎率和多胎妊娠率方面也无显著差异(均 P > 0.05)。两组间在妊娠高血压、妊娠糖尿病、妊娠肝内胆汁淤积症、胎盘异常、多羊水、少羊水、剖宫产率和胎膜早破方面也无明显差异(均 P > 0.05)。然而,单胎活产大于胎龄的发生率差异有统计学意义(P 0.05):结论:无痛取卵术中使用的药物不会影响卵母细胞的受精率、卵泡成熟度、卵裂率和临床妊娠率,也不会增加母体并发症或活产婴儿出生缺陷的风险。这些发现对辅助生殖技术(ART)的安全性具有重要的临床意义。在向患者提供有关辅助生殖技术潜在风险和益处的咨询时,应考虑到观察到的结果,从而有助于患者在知情的情况下做出更好的决定,并提高患者的舒适度。
A retrospective study comparing maternal-infant outcome analysis of live births from patients undergoing painless oocyte retrieval versus conventional oocyte retrieval.
Objective: To investigate the maternal-infant outcomes of live births resulting from painless oocyte retrieval within assisted reproductive technology (ART).
Methods: We conducted a retrospective cohort analysis of clinical data from patients who achieved live births through in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) at the Reproductive Medicine Center of Jiangxi Maternal and Child Health Hospital from September 2021 to May 2023. The study included 5,806 cycles of fresh embryo transfers during the early follicular phase prolonged protocol. Propensity score matching yielded 1,563 cases in both the painless oocyte retrieval group and the control group(the routine oocyte retrieval group). Univariate analysis was utilized to assess differences in basic clinical data, maternal complications, and neonatal birth outcomes.
Results: There was no statistical significance between the two groups in terms of oocyte retrieval numbers, fertilization methods, matured ICSI oocytes, normal fertilized oocytes, normal cleavage oocytes, high-quality embryos, transferable embryos, ICSI oocyte maturation rates, normal fertilization rates, normal cleavage rates, high-quality embryo rates, transplantable blastocyst formation rates, rates of non-transplantable embryos, and fresh embryo transfer rates (all P > 0.05). Similarly, there were no significant differences in the number of embryos transferred, types of embryos transplanted, the presence of at least one high-quality embryo during transplantation, HCG positive rates, biochemical abortion rates, embryo implantation rates, clinical pregnancy rates, abortion rates, live birth rates, single fetus rates, and multiple pregnancy rates between the 2 groups (all P > 0.05). There were also no significant differences in gestational hypertension, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy, placental abnormalities, polyhydramnios, oligohydramnios, cesarean section rates, and premature rupture of membranes between the groups (all P > 0.05). However, there was a statistically significant difference in the incidence of single live births larger than gestational age (P < 0.05). There was no statistically significant difference in sex distribution, preterm and very preterm birth rates, postmature birth rates, proportions of low birth weight, very low birth weight, giant infants, incidences of small for gestational age, and birth defects between the 2 groups (all P > 0.05).
Conclusion: The medication used in painless oocyte retrieval does not impact the fertilization of oocytes, follicular maturation, cleavage, or clinical pregnancy rates, nor does it increase the risk of maternal complications or birth defects in live births. These findings have important clinical implications for the safety of assisted reproductive technologies (ART). The observed results should be considered when counseling patients about the potential risks and benefits of ART, thus contributing to better - informed decisions and enhanced patient comfort.
期刊介绍:
BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.