【摘要】 目的 探讨激素替代周期冻融胚胎移植（FET）患者的妊娠结局及影响因素。方法 回顾性分析2021年7月至2023年12月在我院生殖医学中心行激素替代周期FET治疗患者的临床资料，根据妊娠结局分为临床妊娠组（677个周期）和非临床妊娠组（575个周期），比较两组患者的临床资料，采用单因素、多因素Logistic分析激素替代周期FET患者妊娠结局的影响因素，采用Spearman分析妊娠结局各影响因素的相关性。结果 共纳入1 252个FET周期，其中临床妊娠组共677个周期，临床妊娠率为54.07%。两组患者的年龄、移植日内膜厚度、移植胚胎数、移植优胚数、雌激素应用天数、转化日雌二醇（E₂）、黄体生成素（LH）水平比较均有显著性差异（P<0.05）。单因素Logistic分析结果显示，年龄是影响激素替代周期FET临床妊娠的危险因素，移植日内膜厚度（7～<10mm）、移植胚胎数2枚、移植优胚数2枚、雌激素应用天数（13～18d）、转化日E₂水平（366～<732pmol/L）、转化日LH水平升高均为影响激素替代周期FET临床妊娠的保护因素（P均<0.05）。多因素Logistic回归分析结果显示，年龄是影响激素替代周期FET临床妊娠的危险因素（OR=0.602,P<0.05），移植日内膜厚度（7～<10mm）、雌激素应用天数（13～18d）、转化日E₂水平（366～<732pmol/L）、转化日LH水平升高是影响激素替代周期FET临床妊娠的保护因素（OR分别为1.885、1.893、1.799、1.902,P<0.05）。Spearman分析结果显示，年龄与移植日内膜厚度（7～<10mm）、雌激素应用天数（13～18d）、转化日E₂水平（366～<732pmol/L）、转化日LH水平升高均呈负相关（r分别为-0.421、-0.548、-0.513、-0.540,P<0.05），移植日内膜厚度（7～<10mm）与雌激素应用天数（13～18d）、转化日E₂水平（366～<732pmol/L）、转化日LH水平升高均呈正相关（r分别为0.483、0.502、0.547,P<0.05），雌激素应用天数（13～18d）与转化日E₂水平（366～<732pmol/L）、转化日LH水平升高均呈正相关（r分别为0.463、0.384,P<0.05），转化日E₂水平（366～<732pmol/L）与转化日LH水平升高呈正相关（r=0.611,P<0.05）。结论 激素替代周期FET妊娠结局受到多种因素的影响，主要与年龄、移植日内膜厚度、雌激素应用天数和转化日E₂、LH水平有关。更多还原

【Abstract】 Objective:To explore pregnancy outcomes and influencing factors in patients with frozen embryo transfer（FET）during hormone replacement cycle.Methods:A retrospective analysis was performed on the clinical data of patients who underwent FET in the Reproductive Medicine Center of Maternity and Child Health Care Hospital of Guangxi Zhuang Autonomous Region between July 2021and December 2023.According to pregnancy outcomes,they were divided into clinical pregnancy group（677cycles）and non-clinical pregnancy group（575cycles）.The clinical data in the two groups were compared.The influencing factors of pregnancy outcomes were analyzed by the univariate and multivariate logistic analysis.Spearman analysis was used to evaluate the correlation between influencing factors and pregnancy outcomes in hormone replacement cycles among FET patients.Results:Among the 1 252FET cycles recruited,there were 677cycles of clinical pregnancy,with a clinical pregnancy rate of 54.07%.There were significant differences in age,endometrial thickness on the transfer day,number of embryos transferred,number of high-quality embryos transferred,the duration of estrogen use,the levels of estradiol（E₂）and luteinizing hormone（LH）on the transform day between the two groups（P<0.05）.The results of univariate logistic analysis showed that age was a risk factor of clinical pregnancy,while 7to less than 10mm of endometrial thickness on the transfer day,2transferred embryos and 2high-quality ones,13to 18days of estrogen use,366to less than 732pmol/L of E₂level and increased LH level on the transform day were all protective factors of clinical pregnancy during hormone replacement cycle in FET patients（P<0.05）.The results of multivariate logistic regression analysis showed that age was a risk factor of clinical pregnancy during hormone replacement cycle in FET patients（OR=0.602,P<0.05）,while 7to less than 10mm of endometrial thickness on the transfer day,13to 18days of estrogen use,366to less than 732pmol/L of E₂level and increased LH level on the transform day were protective factors of clinical pregnancy during hormone replacement cycle in FET patients（OR=1.885,1.893,1.799,1.902,P<0.05,respectively）.The results of Spearman analysis showed that the age was negatively correlated with 7to less than 10mm of endometrial thickness on the transfer day,13to 18days of estrogen use,366to less than 732pmol/L of E₂level and increased LH level on the transform day（r=-0.421,-0.548,-0.513,-0.540,P<0.05,respectively）,and 7to less than 10mm of endometrial thickness on the transfer day was positively correlated with 13to 18days of estrogen use,366to less than732pmol/L of E₂level and increased LH level on the transform day（r=0.483,0.502,0.547,P<0.05,respectively）,and 13to 18days of estrogen use was positively correlated with 366to less than 732pmol/L of E₂level as well as increased LH on the transform day（r=0.463,0.384,P<0.05,respectively）,and 366to less than 732pmol/L of E₂level on the transform day was positively correlated with increased LH level on the transform day（r=0.611,P<0.05）.Conclusions:There are many influencing factors of pregnancy outcomes in FET during hormone replacement cycle,which are mainly related to the age,endometrial thickness on the transfer day,the duration of estrogen use and levels of E₂and LH on the transform day.更多还原