探讨体外受精-胚胎移植(in vitro fertilization and embryo transfer，IVF-ET)中影响胚胎种植(embryo transfer，ET)的相关因素。

选择2007年1月至2009年9月在本中心接受体外受精-胚胎移植和精子卵浆内注射(intracytoplasmic sperm injection，ICSI)治疗患者中，分别选择胚胎种植率为100%，即妊娠胎数等于移植胚胎数的治疗周期47个纳入种植组(n＝47)；种植率为0，治疗周期为131个纳入未种植组(n＝131)。以胚胎种植与否为独立变量，以患者年龄、不孕病因、使用外源性促性腺激素(gonadotropin，Gn)量、注射子宫内膜厚度[注射人绒毛膜促性腺激素(human chorionic gonadotrophin, hCG)日测定]、卵子数、体外受精方式、受精率、正常受精率、多精率、优质胚胎率、胚胎移植时间(月经周期)、移植胚胎卵裂球数及其碎片为非独立变量，采用多因素非条件logistic回归分析影响胚胎种植的相关因素(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象本人的知情同意，并与之签署临床研究知情同意书)。

最终进入logistic回归模型的变量为年龄(OR＝0.844，95%CI 23.10~35.44)、正常受精率(OR＝1.019，95%CI 46.95~100)、优质胚胎率(OR＝1.018，95%CI 28.18~100)、胚胎移植时间(OR＝1.143，95%CI 8.03~29.09)和移植胚胎卵裂球数(OR＝2.840，95%CI 6.78~8.86)。在一定范围内(95%CI)，患者年龄每增加1岁，胚胎种植率下降15.6%；正常受精率每增加1.0%，胚胎种植率增加1.9%；优质胚胎率每增加1.0%，胚胎种植率增加1.8%；胚胎移植时间每增加1 d，胚胎种植率增加14.3%；移植胚胎卵裂球数每增加1个，细胞胚胎种植率增加184.0%。

体外受精-胚胎移植技术中的患者年龄、正常受精率、优质胚胎率、胚胎移植时间(月经周期)、移植胚胎卵裂球数可影响胚胎的种植。

To investigate influential factors on embryo transfer (ET) of in vitro fertilization and embryo transfer (IVF-ET).

From January 2007 to September 2009, people who were received in vitro fertilization and embryo transfer and intracytoplasmic sperm injection (ICSI) were recruited into this study. They were divided into two groups according to implantation rate, implanted group (implantation rate was 100%, n=47) and non-implanted group (implantation rate was 0, n=131). Influential factors on embryo implantation were analyzed by multivariate non-conditional logistic regression analysis by choosing whether embryo implantation or not as the independent variable and age, pathogeny, gonadotropin (Gn) dose, thickness of endometrim [at the day of injecting human chorionic gonadotrophin (hCG)], number of oocytes, in vitro fertilization and embryo transfer or intracytoplasmic sperm injection, fertilization rate, normal fertilization rate, poly spermic fertilization rate, high-quality embryo rate, embryo transfer time (menstrual cycle), and cell number of embryo transfer and fragment on embryo implantation as the independent variable. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Tianjin Medical University General Hospital. Informed consent was obtained from all participants.

Variables in the equation of logistic regression were age (OR=0.844, 95%CI 23.10-35.44), normal fertilization rate (OR=1.019, 95%CI 46.95-100.00), high-quality embryo rate(OR=1.018, 95%CI 28.18-100.00), embryo transfer time (menstrual cycle) (OR=1.143, 95%CI 8.03-29.09), cell number of embryo transferred (OR=1.775, 95%CI 6.78-8.86). Within a certain extent (95%CI), embryo implantation rate decreased 15.6% when the age with additional 1 year; normal fertilization rate increased by 1.0% when embryo implantation rate increased by 1.9%; embryo implantation rate increased by 1.8% when high-quality embryo rate increased by 1.0%; implantation rate increased by 14.3% when embryo transfer time with additional 1 d; cell implantation rate increased by 184.0% when the cell number of embryo transferred increased by 1.

Age, normal fertilization rate, high-quality embryo rate, embryo transfer time (menstrual cycle), cell number of embryo transferred are the influential factors on embryo implantation of in vitro fertilization and embryo transfer.