目的 探讨自然周期和激素替代周期这2种内膜准备方案,对有异位妊娠史患者冷冻胚胎移植周期妊娠结局的影响。方法 回顾性分析行体外受精/卵细胞质内单精子显微注射及冷冻胚胎移植且有异位妊娠史的914例患者,并通过倾向性得分匹配的方法对采用自然周期进行内膜准备的患者（428例）和采用激素替代周期进行内膜准备的患者（486例）进行匹配,最终获得匹配周期379对,分为自然周期组和激素替代组,比较2组的妊娠结局。结果 自然周期组与激素替代组在年龄、体质量指数、先前足月产数、输卵管手术史、原发或继发不孕、诊断、移植日内膜厚度、移植胚胎数、移植胚胎阶段和治疗年份等基本特征上的差异均无统计学意义（P>0.05）。妊娠结局方面,2组患者的异位妊娠发生率并无统计学差异（5.2%比7.5%,P>0.05）,而2组间的生化妊娠率、临床妊娠率、分娩率、流产率和多胎率等指标差异也均无统计学意义（P>0.05）。结论 在冷冻胚胎移植周期中,对有异位妊娠史的患者采用自然周期或激素替代周期进行内膜准备,患者异位妊娠的复发风险相似,并可获得相似的妊娠结局。
Objective: To evaluate the effect of different endometrial preparation on outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) frozen-thawed embryo plantation in patients with history of ectopic pregnancy. Methods: Data from 914 patients with history of ectopic pregnancy who underwent IVF/ICSI frozen-thawed embryo plantation from January 2012 to December 2014 were collected. Patients undergoing natural cycles and those undergoing artificial cycles were matched into 379 pairs by propensity score matching. Pregnancy outcomes were compared between the two matched groups of patients. Results: The basic characteristics including maternal age, body mass index, full-term birth history, primary or secondary infertility, previous tubal surgery history, infertility diagnosis, endometrial thickness on embryo plantation day, number and stage of embryos planted, and year of treatment were not significantly different between the two groups (P>; 0.05). As for pregnancy outcome, the ectopic pregnancy rate of the two groups was not significantly different (5.2% vs.7.5%, P>; 0.05). Moreover, biochemical pregnancy rate, clinical pregnancy rate, delivery rate, miscarriage rate, and multiple pregnancy rate of the two groups were also not significantly different (P>; 0.05). Conclusions: In IVF/ICSI frozen-thawed embryo plantation, natural cycles and artificial cycles have similar effect on recurrence risk of ectopic pregnancy, and have comparable pregnancy outcome.
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