选择性双胚胎移植对IVF-ET妊娠结局的影响  

Effects of elective double embryo transfer on pregnancy outcome in IVF-ET

作　　者：董胜男[1] 刘炜[2] 王炎秋[1] 周围[1] 石礼红[1] 赵起越[1] 谢晓东[1] 纪亚忠[1] 

机构地区：[1]同济大学附属同济医院生殖医学科,上海200065 [2]山东建筑大学附属校医院,济南250101

出　　处：《生殖医学杂志》2015年第12期988-992,共5页Journal of Reproductive Medicine

摘　　要：目的探讨体外授精-胚胎移植(IVF-ET)中,选择性双胚胎移植对妊娠结局的影响。方法收集在上海市同济医院生殖中心从2012年6月至2014年5月行两枚第3天胚胎移植的517个周期,按照移植胚胎的形态学评分分为三组:A组为移植两枚Ⅰ级胚胎(304个周期);B组移植一枚Ⅰ级胚胎和一枚低级别的胚胎(128个周期);C组为移植两枚非Ⅰ级胚胎(85个周期)。分别对各组间的患者年龄、不育年限、不育因素以及临床妊娠率、抱婴率、活产率等临床结局进行统计学比较。结果 3组每移植周期的临床妊娠率和抱婴率依次降低,分别为73.7%、62.5%、43.5%和62.1%、51.6%、36.5%,组间均有统计学差异(P<0.05);3组间的异位妊娠率、早期流产率、晚期流产率和活产率差异均无统计学意义(P>0.05);C组的生化妊娠率显著高于A、B两组(P<0.05),A、B组间差异不显著(P>0.05);A组的胚胎活产率显著高于B、C两组(P<0.05),B、C组间差异不显著(P>0.05)。结论胚胎形态学分级可以作为评判胚胎发育潜能的参数,Ⅰ级胚胎可获得最好的临床妊娠率和胚胎活产率;胚胎成功种植后,胚胎形态学分级不影响妊娠结局。Objective：To investigate the effect of elective double embryo transfer on pregnancy outcome in IVF-ET.Methods：The data of double embryos transfer of day 3from June 2012 to May 2014 in Reproductive Medicine Center of Tongji Hospital were retrospectively analyzed.A total of 517 cycles were divided into three groups according to the morphological scores of transferred embryos.Group A had two top quality embryos for transfer（304cycles）,group B only one top quality embryo（128cycles）and group C two nontop quality embryos（85 cycles）.The patients＇ age,duration of infertility,infertile causes,clinical pregnancy rate,take-home baby rate,live birth rate and other clinical outcome were compared among the three groups.Results：The clinical pregnancy rate per transfer cycle was 73.7%,62.5% and 43.5%,and the corresponding take-home baby rates per transfer cycle were 62.1%,51.6%and 36.5%in group A,B and C respectively,which significantly reduced along with the decrease of embryo morphological grade（P〈0.05）.However,there were no significant differences in ectopic pregnancy rate,early abortion rate,late abortion rate and live birth rate among the three groups（P〉0.05）.The biochemical pregnancy rate ingroup C was significantly higher than that in group A and B（P〈0.05）,but there was no significant difference between group A and group B（P〉0.05）.The live birth rate per transfer embryo was significantly higher in group A than that in group B and C（P〈0.05）,but no significant difference was found between group B and C（P〉0.05）.Conclusions：Embryo morphological grade could be used as a parameter to evaluate the potential of embryo development.The optimum clinical pregnancy rate and live birth rate per embryo could be achieved by transferring grade I embryos.Once the clinical implantation is established,the morphological grade of embryo would not influence pregnancy outcome.

关 键 词：辅助生殖技术 卵裂期胚胎 胚胎移植 抱婴率 

分 类 号：R[医药卫生]