冻融胚胎移植术用于补救卵胞浆内单精子注射治疗周期的临床价值  

Clinical value of frozen-thawed embryo transfer in rescue intracytoplasmic sperm injection cycles

作　　者：张琪瑶[1] 闻姬[1] 管群[1] 菅福琴[1] 

机构地区：[1]山东中医药大学第二附属医院生殖科,济南250001

出　　处：《现代妇产科进展》2013年第10期824-826,830,共4页Progress in Obstetrics and Gynecology

基　　金：山东省自然科学基金(No:Y2007C136)

摘　　要：目的：探讨冻融胚胎移植在补救卵胞浆内单精子注射（ICSI）治疗周期中的临床价值。方法：回顾分析常规体外受精完全失败的306个周期，根据补救ICSI的时间不同分为6～8h补救ICSI组（A组）和18～20h补救ICSI组（B组），其中行新鲜胚胎移植且有胚胎冷冻的分别记为AI组（n=108）和BI组（n=51），随后行冻融胚胎移植的分别记为AⅡ组（n：74）和BⅡ组（n=46），观察各组的妊娠结局。结果：A组正常受精率、卵裂率、优质胚胎率和临床妊娠率均明显高于B组（P〈0．05）；BⅡ组临床妊娠率和胚胎种植率明显高于BI组（32．61％VS11．76％，15．08％VS5．04％，P〈0．05）；AII组临床妊娠率和胚胎种植率较AI组高（44．59％VS34．26％，21．86％VS19．40％），但无明显的统计学差异（P〉0．05）。结论：合理的补救时间是影响补救ICSI结局的关键因素，进一步的冻融胚胎移植可以改善补救ICSI治疗周期的妊娠结局。Objective：To study the clinical value of frozen-thawed embryo transfer in rescue intracytoplasmic sperm injection cycles. Methods：We performed a retrospective analysis of 306 rescue intracytoplasmic sperm injection （ICSI） cycles, which were carried out after total fertilization failure in conventional in vitro fertilization （IVF） cycles. According to the time for rescue ICSI, these cycles were divided into two groups. Group A included women who performed ICSI 6 -8h after insemination. Group B was 18 -20h after insemination. In these cycles, after fresh embryos implantation, if women still had embryos for freezing, they would be attribute to A I （n= 108） and B Ⅰ （n=51） groups respectively. If the frozen embryos were thawed and im- planted, the patients would be attributed into A U （ n. = 74 ） and B II （ n = 46 ） group further. The outcomes of pregnancy of these patients were analyzed. Results：The normal fertilization rate, cleavage rate, high-quality embryo rate and clinical pregnancy rate in group A were signifi- cantly higher than those in group B （ P 〈 0.05 ）. Significantly higher clinical pregnancy rate （32.61% vs 11.76% ,P〈0.05 ） and implantation rate （ 15.08% vs 5.04%, P〈0.05 ） were achieved in group B Ⅱ compared with group B Ⅰ . The clinical pregnancy and implantation rates of group A Ⅲ were higher than group A I （44.59% vs 34.26% ,21.86% vs 19.40% ,P〉 0.05 ） , but there were no significant differences between the two groups. Conclusions ： Reasona- ble rescue time is the key of the outcome in rescue ICSI. It is helpful that embryos derived fromrescue ICSI cycles are cryopreserved and subsequently used in frozen-thawed cycles.

关 键 词：体外受精 补救卵胞浆内单精子注射 冻融胚胎移植 子宫内膜 同步性 

分 类 号：R714.8[医药卫生—妇产科学]