囊胚培养患者选择标准的建立及临床应用研究  

The Establishment and Clinically Applicable Study of Patient Selection Criteria for Blastocyst Culture

作　　者：敖磊[1] 马艳萍[1] 高梦莹[1] 邓莲[1] 相立峰[1] 李明颖[1] 李永刚[1] 

机构地区：[1]云南省第一人民医院,云南昆明650032

出　　处：《实用妇产科杂志》2015年第2期143-146,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:旨在建立一套能使更多患者从囊胚培养和移植中受益的选择标准。方法:回顾性分析2011年3月至2012年10月在云南省第一人民医院生殖医学中心实行的两套囊胚培养患者的选择标准。旧标准(844周期):D3选择2个评分最高的胚胎进行移植或冷冻后,若剩余胚胎≥7个,行囊胚培养;新标准(781周期):D3选择2个评分最高的胚胎进行移植或冷冻后,若剩余胚胎≥5个,行囊胚培养。对两组患者IVF的治疗结局进行比较。结果:新标准组患者的获卵数(18.01±7.01个)低于旧标准组(19.42±6.27个),差异有统计学意义(P=0.006);新标准组的患者无囊胚形成率(5.6%)高于旧标准组(2.3%),差异有统计学意义(P=0.001)。新、旧标准两组患者在囊胚形成率、优质囊胚形成率、囊胚复苏率、每周期冻融胚胎移植数、冻融囊胚移植临床妊娠率、囊胚种植率、多胎率和流产率上比较,差异均无统计学意义(P>0.05)。结论:降低囊胚培养患者的选择标准可以使更多患者从囊胚培养和移植中受益。Objective： To compare two patient selection models for blastocyst culture which benefitmore patientsin a homogenous clinical setting. Methods： Two differentpatient selection criteria for blastocyst culture were analyzed retrospectivelyin the First People＇s Hospital of Yunnan Province from March,2011 to October,2012. Old patient selection criteria（ 844 cycles） ： Blastocyst cultures were donewhen the surplus number of embryos were equal or greater than 7,after two highest-quality embryos were transferred or frozen. New patient selectioncriteria（ 781 cycles） ： Blastocyst cultures were done when the surplus number ofembryos were equal or greater than 5,after two highest-quality embryos weretransferred or frozen. IVF outcomes were compared respectively between thesetwo criteria. Results： Oocyte number of patients（ 18. 01±7. 01） for new criteria significantly decreased incomparison with that of old criteria（ 19. 42±6. 27）（ P = 0. 006）. No blastocyst formation rate ofpatients for new criteria（ 5. 6%） significantly increased incomparison with old criteria（ 2. 3%）（ P=0. 001）. No significant differences were noted in age,blastcyst formation rate,survival rate of blastcyst,clinical pregnancy rate,implantation rate,multiple pregnancy rate and abortion rate between these twocriteria（ P〉0. 05）. Conclusions： The results of this study revealthat lowering the blastocyst selection criteria increases the number ofpatients who will benefit from the blastocyst culture and transfer.

关 键 词：囊胚培养 囊胚移植 临床妊娠率 选择标准 

分 类 号：R321.3[医药卫生—人体解剖和组织胚胎学]