The Journal of Practical Medicine >

2024 , Vol. 40 >Issue 17: 2390 - 2394

DOI: https://doi.org/10.3969/j.issn.1006-5725.2024.17.006

Clinical Research

Strategy for frozen⁃thawed cycle blastocyst transfer after hysteroscopic adhesiolysis

  • Cheng LIU ,
  • Meiying SANG ,
  • Qunying FANG ,
  • Shun BAI ,
  • Meihong HU ,
  • Shengxia. ZHENG
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  • Center for Reproduction and Genetics，the First Affiliated Hospital，USTC，Hefei 230001，China

Received date: 2024-04-11

  Online published: 2024-09-13

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Abstract

Objective To explore the assisted reproductive strategy and influencing factors for patients undergoing frozen?thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for intrauterine adhesions. Methods A total of 275 patients who underwent frozen?thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for infertility reasons at the Reproductive Genetics Center of the First Affiliated Hospital of University of Science and Technology of China from January 2018 to December 2022 were included in the study. They were divided into a single blastocyst transfer group （n = 182） and a double blastocyst transfer group （n = 93）. The clinical outcomes were analyzed and compared retrospectively between the group. Results The two groups showed no statistically significant differences in terms of age， day of endometrial thickness conversion， endometrial preparation method， clinical pregnancy rate， miscarriage rate， preterm birth rate， gestational week at delivery， and mode of delivery （P > 0.05）. The single blastocyst transfer group had significantly lower infertility duration （years） （2.43 ± 1.64 vs. 3.03 ± 2.13， P < 0.05）， significantly lower AFS prognosis score （5.13 ± 2.25 vs. 5.72 ± 2.19， P < 0.05）， and significantly lower multiple pregnancy rate （1.33% vs. 28.57%， P < 0.05）， but significantly higher quality embryo rate （90.66% vs. 46.24%， P < 0.05）， implantation rate （50.00% vs. 34.41%， P < 0.05）， and live infant mass （g） （3 236.84 ± 565.35 vs. 2 976.44 ± 692.79， P < 0.05） compared to the double blastocyst transfer group. Binary logistic regression analysis showed that the number of high?quality embryos transferred and AFS score were independent influencing factors for clinical pregnancy （P < 0.05）. Conclusions The number of high?quality embryos transferred and the AFS score are independent influencing factors for clinical pregnancy in patients undergoing frozen?thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for intrauterine adhesions. Single high?quality blastocyst transfer is a preferred treatment for patients after hysteroscopic adhesiolysis， and double blastocyst transfer is favorable for patients with a poor prognosis to achieve better pregnancy outcomes.

Key words： intrauterine adhesion; frozen?thawed cycle; blastocyst; factors; pregnancy outcome

Cite this article

Cheng LIU , Meiying SANG , Qunying FANG , Shun BAI , Meihong HU , Shengxia. ZHENG . Strategy for frozen⁃thawed cycle blastocyst transfer after hysteroscopic adhesiolysis[J]. The Journal of Practical Medicine, 2024 , 40(17) : 2390 -2394 . DOI: 10.3969/j.issn.1006-5725.2024.17.006

References

1 夏恩兰. 宫腔镜学及图谱［M］. 2版，郑州：河南科学技术出版社，2009：279-297.
2 何均，刁红录，张昌军，等. 宫腔镜下宫腔粘连分离术后行体外受精-胚胎移植的妊娠结局及影响因素［J］. 实用妇产科杂志，2019，35（12）：941-944.
3 The American Fertility Society classifications of adnexal adhesions， distal tubal occlusion， tubal occlusion secondary to tubal ligation， pregnancies tubal， mullerian anomalies and intrauterine adhesions［J］. Fertil Steril，1988，49（6）：944-955. doi:10.1016/s0015-0282(16)59942-7
4 刘景瑜，朱颖春，孔娜，等. 薄型子宫内膜患者冻融胚胎移植周期17β雌二醇、人绝经期促性腺激素及他莫昔芬三种内膜准备方案临床结果比较［J］. 生殖医学杂志， 2018，27（2）：112-116. doi:10.3969/j.issn.1004-3845.2018.02.003
5 李静，乔洪武，管一春，等. 单囊胚移植在新鲜移植周期与冻融移植周期中的应用［J］. 深圳中西医结合杂志， 2019，29（8）：10-11. doi:10.16458/j.cnki.1007-0893.2019.08.004
6 EMILY C H， BANAFSHEH N K， SARA S M，et al. Improved outcomes after blastocyst-stage frozen-thawed embryo transfers compared with cleavage stage： a society for assisted reproductive technologies clinical outcomes reporting system study［J］.Fertil Steril，2018，110（1）：89-94. doi:10.1016/j.fertnstert.2018.03.033
7 MATHEUS R， KARINNA L， SANDRA S，et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles： a systematic review and meta-analysis［J］. Fertil Steril，2013，99（1）：156-162. doi:10.1016/j.fertnstert.2012.09.003
8 DENG K， SONG X H， HAN X M， et al. Optimal waiting period for fresh embryo transfer after hysteroscopic adhesiolysis： a retrospective cohort study［J］. Chin Med J （Engl）， 2019， 132（19）： 2333-2339. doi:10.1097/cm9.0000000000000456
9 YIMIN Z， MINYUE T， YANLING F， et al. Fetal reduction could improve but not completely reverse the pregnancy outcomes of multiple pregnancies： experience from a single center［J］. Front Endocrinol （Lausanne）， 2022，24（13）：851167.
10 ELINE M， LAURA D R， ESMEE M B，et al. Birth outcomes of twins after multifetal pregnancy reduction compared with primary twins［J］. Am J Obstet Gynecol MFM， 2024，6（1）：101230. doi:10.1016/j.ajogmf.2023.101230
11 XIN L， YI W， TING L，et al. Clinical outcomes of vanishing twin syndrome and selective fetal reduction after double embryos transferred in IVF pregnancy： A propensity score matching study［J］.Eur J Obstet Gynecol Reprod Biol， 2023， 289：48-54. doi:10.1016/j.ejogrb.2023.08.372
12 高红，王蔼明，林莉，等. 新鲜周期选择性单囊胚与双囊胚移植临床结局的比较［J］. 生殖医学杂志， 2017，26（12）：1182-1186. doi:10.3969/j.issn.1004-3845.2017.12.004
13 刘景，孔红娇，胡继君，等. 冷冻复苏周期不同囊胚移植方案对不同年龄患者妊娠结局的影响［J］. 实用医学杂志， 2020，36（7）：925-929. doi:10.3969/j.issn.1006-5725.2020.07.018
14 李明颖，马艳萍，高梦莹，等. 囊胚质量对冻融胚胎移植临床结局的影响及囊胚移植选择策略［J］. 实用医学杂志， 2018，34（15）：2453-2456. doi:10.3969/j.issn.1006-5725.2018.15.001
15 HADAS G H， ALEXANDER V P， TUYET N T N，et al. Does embryo quality at transfer affect obstetric outcomes and placental findings？［J］. Hum Reprod， 2023，38（5）：853-859. doi:10.1093/humrep/dead045
16 SAMUEL J A， MARIA T L， ESSAM M，et al. Effect of transfer of a poor quality embryo along with a top quality embryo on the outcome during fresh and frozen in vitro fertilization cycles［J］. Fertil Steril， 2018，110（4）：655-660. doi:10.1016/j.fertnstert.2018.05.010
17 季晓媛，赵纯，李秀玲，等. 宫腔粘连术后影响FET成功率的临床因素探讨［J］. 中国妇幼健康研究， 2016，27（4）：493-496. doi:10.3969/j.issn.1673-5293.2016.04.026
18 周晓景，谭丽，王芬，等. 宫腔粘连分离术后冻融胚胎移植周期轻刮子宫内膜对改善妊娠结局的影响研究［J］. 中国实用妇科与产科杂志， 2017，33（1）：114-117.
19 王玉清，刘竞京，郭子珍，等. 宫腔粘连分离术后行鲜胚移植活产的影响因素分析［J］. 现代妇产科进展， 2022，31（1）：11-14. doi:10.13283/j.cnki.xdfckjz.2022.01.002
20 段华，夏恩兰，王素敏，等. 宫腔粘连临床诊疗中国专家共识［J］. 中华妇产科杂志，2015，50（12）：881-887.
21 CHEN L， ZHANG H， WANG Q，et al. Reproductive outcomes in patients with intrauterine adhesions following hysteroscopic adhesiolysis： experience from the largest women's hospital in China［J］. J Minim Invasive Gynecol，2017，24（2）：299-304. doi:10.1016/j.jmig.2016.10.018
22 EVANS H E A， YOUNG S L. Endometrial receptivity and intrauterine adhesive disease［J］. Semin Reprod Med， 2014，32（5）：392-401. doi:10.1055/s-0034-1376358
23 KAMATH M S， CHITTAWAR P B， KIRUBAKARAN R，et al. Use of granulocyte-colony stimulating factor in assisted reproductive technology： A systematic review and meta-analysis［J］. Eur J Obstet Gynecol Reprod Biol，2017，214：16-24. doi:10.1016/j.ejogrb.2017.04.022
24 MANSOUR R， TAWAB N， KAMAL O，et al. Intrauterine injection of human chorionic gonadotropin before embryo transfer significantly improves the implantation and pregnancy rates in in vitro fertilization/intracytoplasmic sperm injection： a prospective randomized study［J］. Fertil Steril， 2011，96（6）：1370-1374. doi:10.1016/j.fertnstert.2011.09.044
25 CUI N， LI A M， LUO Z Y，et al. Effects of growth hormone on pregnancy rates of patients with thin endometrium［J］. J Endocrinol Invest，2019，42（1）：27-35. doi:10.1007/s40618-018-0877-1
26 SHREYA P， SANDHYA P， TANMAY T. Recent advancement in the management of intrauterine adhesions using stem cell therapy： a review article［J］. Cureus， 2023，15（8）：e43553.
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