年龄、移植胚胎数量、质量与临床妊娠率的关系  

Effect of number and quality of embryo transferred on clinical pregnancy rate in women of different age

作　　者：罗燕群[1] 刘风华[1] 易艳红[1] 吴敬之[1] 黄翠玉[1] 朱秀兰[1] 张曦倩[1] 董梅[1] 周娜[1] 郑毅春[1] 

机构地区：[1]广东省妇幼保健院生殖医学中心,广州市510010

出　　处：《生殖医学杂志》2014年第5期361-366,共6页Journal of Reproductive Medicine

摘　　要：目的探讨重复周期体外受精-胚胎移植（IVF-ET）中胚胎移植数量、质量对不同年龄阶段妇女IVF—ET妊娠率和多胎妊娠率的影响。方法772个行第二次IVF-ET的取卵周期，按年龄分三组（〈35周岁、35～37周岁和≥38周岁），以移植胚胎数量不同分为两组（A组，移植2个胚胎；B组，移植3个胚胎）；再根据移植优质胚胎的个数将A组分别细分为A0、A1和A2组（优质胚胎移植数分别为0、1和2），同法B组分为B0、B1、B2和B3组（优质胚胎移植数分别为0、1、2和3）。比较临床妊娠率、多胎发生率等多项指标的差异。结果（1）〈35周岁组：A组和B组临床妊娠率无显著差异（49．4％vs．42．5‰，P〉0．05）；A组的单胎妊娠率显著高于B组（75．3％VS．55．6％，P〈0．05），而3胎妊娠率显著低于B组（0％VS．9．8％，P〈0．05），其中B2组和B3组的单胎妊娠率低于A2组（P〈0．05），而3胎妊娠率高于A2组（P〈0．05）。（2）35～37周岁组：A、B两组的妊娠率无统计学差异（P〉0．05）；A组的单胎妊娠率显著高于B组（86．7％VS．54．8％，P〈0．05），双胎妊娠率显著低于B组（6．7％vs．35．7％，P〈0．05）；A0组无胚胎种植，BO组获得11．1％种植率和29．2％妊娠率（P〈0．05）；A1组无双胎妊娠发生，但B1组双胎妊娠率为45．5％（P〈0．05）；132组双胎率显著高于A2组（53．3％VS．11．1％，p〈0．05）。（3）≥38周岁组：A、B两组临床妊娠率无统计学差异，但B组妊娠率相对较高（23．7％VS．10．0％，P〉0．05）。结论年龄≥38周岁及无优质胚胎可移植的年龄35～37周岁妇女，增加移植胚胎数至3个，可能增加临床妊娠率；而对于〈38周岁尤其是〈35周岁的重复IVF—ET不育妇女，临床上有优质胚胎可移植时，移植胚胎数由3个降至2个可能并不降低临床妊娠率，但可以降低多胎妊娠率。Objective： To evaluate the effects of number and quality of embryo transferred oia pregnancy and multiple pregnancy rates in women of different age. Methods：According to age, 772 women in the second cycle of in vitro fertilization-embryo transfer （IVF-ET）were classified into three groups（〈35 years, 35-37 years,and≥38 years）. According to different number of embryo transferred,the patients in each age group were divided into two subgroups：group A （double embryos transferred）and group B（three embryos transferred）. Furthermore, according to the different number of good embryo transferred, group A was classified into group A0, group A1 and group A2. The group B was also classified into group B0, group B1, group B2 and group B3. Pregnancy and multiple pregnancy rates were compared. Results： （t） For women younger than 35 years group B （ 49.4 % vs. 42.5 % ） （ P 〉 0.05 ） . The old, the pregnancy rate of group A was similar with incidence of singleton pregnancy in group A was pregnancy in group A was significantly lower than that in group B（0% vs. 9.8%）（P〈0.05）. The incidence of singleton pregnancies in group B2 or group B3 was significantly lower than that in group A2 （P〈0.05）. The incidence of triplet pregnancy in group B2 or group B3 was significantly higher than that in group A2 （P〈0.05）. （2）For women aged 35-37 years, the pregnancy rate in group A was similar with group B（P〉0.05）. The incidence of singleton pregnancy in group A was significantly higher than that in group B（86.7% vs. 54.8%）（P〈0.05）. The incidence of twin pregnancy in group A was significantly lower than that in group B（6.7% vs. 35.7%） （P〈0.05）. The pregnancy rate in group B0 was significantly higher than that in group A0 （29.2 % vs. 0 %）（P〈0.05）. The incidence of twin pregnancy in groupB1 was significantly higher than that in group A1（45.50% vs. 0%）（P〈0.05）. The incidence of twin pregnancy in group B2 was significantly higher than that i

关 键 词：体外受精-胚胎移植 移植胚胎数 胚胎质量 临床妊娠率 

分 类 号：R[医药卫生]