| Objective: To investigate Effect of PZD on the clinical outcome of the vitrified-warmed embryo transfer cycles in advanced age women(over 38years).Methods: A retrospective analysis was performed about vitrified-warmed embryo transfer cycles in aged patients from January 2014 to June 2016 at our reproductive center.Totally 239 cases were included,of which 61 cases undergoing assisted hatching(AH)and 178 cases of without assisted hatching,and the clinical,laboratory information and pregnancy outcomes of the two groups were compared.Logistic regression model with a dichotomous variable was established to remove the confounding factors affecting clinical pregnancy,to further analyze the effect of PZD on clinical pregnancy outcome.Results: Patients were slightly younger in AH group(39.90+2.23 VS40+2.67,P=0.022),but had longer infertile years(7.57+5.34 VS 5.94+5.08,P=0.020).The days of embryonic development was longer in group AH than that in NAH group(3.33+0.54 VS 3.18+0.44,P=0.020).However,the infertile years and the days of embryonic development had no significant effect on the clinical pregnancy rate in the Logistic regression results.Multi-logistic regression model showed that after the removal of other confounding factors such as age,endometrial preparation and other confounding factors,the effect of assisted hatching on clinical pregnancy was improved,but the effect was not statistically significant(OR=1.374,95%CI 0.720-2.621,P=0.335).Conclusion: Mechanical assisted hatching has a tendency to increase the clinical pregnancy rate of vitrified-warmed embryo transfer in elderly patients,but there is no statistical significance.In patients over 38 years old,the clinical pregnancy of vitrified-warmed embryo transfer may be reduced by about 16%per age.It is still unclear whether assisted hatching will affect the live birth rate in frozen-thawed embryo transfer,prospective studies of large samples are still needed. |
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