《生殖医学》新鲜周期或冻融周期移植.ppt

新鲜周期或冻融周期移植——这是个问题?新鲜与冻融周期移植历史发展与目前趋势thefirstpregnancyofathawedcryopreservedhumanembryowasreportedin1983inAustralia,herlands1988年AFS(ASRM)的IVFspecialinterestgroup(SART)首次报告1985至1986年ART数据:822个总妊娠中7个FET妊娠,FET小于1%In1995,SARTcollaboratedwithCDCtopublishdata:1282FETbirthsamong12000deliveries,FET>10%In2012,15408FETbirths,accounting1/3ARTbirths新鲜与冻融周期移植历史发展与目前趋势新鲜与冻融周期移植历史发展与目前趋势Initially,essrate,allavailableembryosweretransferredinIVFtreatments,thatistosay,freshETalmostalwayscoincidedwithstimulationimprovementsofclinicalandlaboratoryaspectsofIVF(multiplefollicularstimulations,eggretrieval,cultureconditions)increasedpregnancyratesincreasedriskofmultiplepregnanciesfewerembryostransferredsupernumerary(secondbest)‘‘trigger’’Accumulationofeggs/hemotherapyisplannedorarewishingtodelaypregnancyformorethan1years新鲜与冻融周期移植历史发展与目前趋势超排导致的非(超)生理围植入期环境的影响SuperovulationisanintegralpartofIVFandresultsinsupraphysiologiclevelsofmultiplehormonesandotherfactors,includingE2,P,(supra)physiologic(peri-implantation)environmentduringoocytedevelopmentandafterembryotransfer,havingmultipleeffectstooocyte,endometrium,andimplantingembryoEffectonoocyte超排导致的非(超)生理围植入期环境的影响