卵裂球的完整性和生长与否对冻融胚胎移植妊娠结局的影响  

Impact of Blastmere Survival and Resumption of Cleavage on the Outcome of Frozen-thawed Embryo Transfer

作　　者：陆湘[1] 李路[1] 高晓红[1] 吴煜[1] 王永卫[1] 孙健[1] 陶皆惟[1] 孙晓溪[1] 

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院生殖医学中心,上海200030

出　　处：《生殖与避孕》2007年第8期518-522,共5页Reproduction and Contraception

摘　　要：目的:探讨冻融胚胎移植(FET)周期卵裂球的完整性和生长与否对妊娠结局的影响。方法:375例FET周期,其中解冻当天移植周期242例,提前解冻周期133例,根据复苏后移植卵裂球的完整性分为3组:均完整(A组,n=235)、均有破损(B组,n=21)、完整与破损混合(C组,n=119);提前解冻者根据卵裂球的生长与否分为均有生长74例(Ⅰ组)、部分有生长45例(Ⅱ组)和均无生长14例(Ⅲ组)3组。结果:375例FET周期共解冻胚胎1284个,复苏率为61.2%,每移植周期临床妊娠率30.1%,种植率18.3%;A组的继续妊娠率和种植率分别为27.7%和20.5%,明显高于B组的9.5%和8.3%(P<0.05),C组为22.7%和15.1%,低于A组,但差异无统计学意义(P>0.05)。随着移植胚胎中含完整存活胚胎数的增加(0个、1个、2个、3个),继续妊娠率呈增加趋势(9.5%、17.6%、22.3%和38.2%),移植胚胎中含3个完整胚胎的继续妊娠率明显高于含0、1个完整胚胎者(P<0.05);提前解冻的Ⅰ组继续妊娠率(37.8%)和种植率(26.1%)最高,Ⅲ组最低(7.1%和8.3%),Ⅱ组为24.4%和14.1%,组间差异均有统计学意义(P<0.05)。结论:卵裂球的完整性是影响冻融胚胎种植率的重要因素,移植前提早解冻观察复苏后胚胎有无进一步生长,有助于评价冻融胚胎的发育潜能。Objective： To analysis the impact of blastmere survival and resumption of cleavage on the outcome of FET. Methods： A retrospective analysis was performed on 375 FET cycles,involving 242 thawed-day transfer cycles and 133 in advanced thawed transfer cycles. The cycles were categorized into 3 groups： group A （n=235） included cycles in which all blastmeres were intact; group B （n=21） included cycles in which all blastmeres were partially damaged and group C refered to mixed transfer with intact embryos and partially damaged ones. According to whether or not resumption of mitosis during post-thawed culture, the following 3 types of transfer were used： 74 （group Ⅰ ） transfer exclusively of embryos having continued to cleave after thawing; 45 （group Ⅱ ） mixed transfers of embryos with and without further cleavage and 14 （group Ⅲ） transfers exclusively of embryos with no further cleavage. Results： A total of 1 284 embryos were thawed in 375 transfer cycles, resulting in survival rate of 61.2% and implantation rate of 18.3%. The continued pregnancy rate and implantation rate were significantly higher in group A than in group B （27.7% and 20.5% vs 9.5% and 8.3%, respectively）, along with the increase of the number of intact embryo in transfer cycles （0, 1, 2, 3）, the continued pregnancy rate showed a increased trend （9.5 %, 17.6%, 22.3 % and 38.2 %）, especially those cycles in which 3 intact embryos were transferred, there was a significant difference when compared with 0-1 intact embryos transfer cycles （P〈0.05）. The clinical pregnancy rate was higher in advanced thawed cycles than those cycles thawed on the transfer day （39.2 % vs 28.1%, P〈0.05）, in earlier thawed cycles, transfer exclusively cleaved embryos resulted the highest continued pregnancy rate and implantation rate compared with group Ⅱ and group Ⅲ （37.8%and 26.1% vs 24.4% and 14.1% vs 7.1% and 8.3%, respectively, P〈0.05）. Conclusion： Blastmere survival status is an important factor influe

关 键 词：冻融胚胎移植(FET) 卵裂球 妊娠率 种植率 

分 类 号：R714.8[医药卫生—妇产科学]