卵裂期冻融复苏胚胎进一步发育情况对临床结局的影响  

Impact of further development of frozen-thawed embryo on clinical outcome

作　　者：惠董娜[1] 任文娟[1] 雷鑫[1] 刘建荣[1] 王怀秀[1] 李弘[1] 

机构地区：[1]山西省人民医院生殖医学科,太原030012

出　　处：《生殖医学杂志》2017年第1期19-23,共5页Journal of Reproductive Medicine

摘　　要：目的探讨卵裂期冻融复苏胚胎过夜培养后胚胎生长个数及卵裂球增殖情况对临床结局的影响。方法回顾性分析我中心268个卵裂期FET周期,根据过夜培养后复苏胚胎的生长个数分为0个生长组(A1,n=46)、1个生长组(A2,n=48)和2个及以上生长组(A3,n=174);根据卵裂球增殖情况分为<8细胞组(B1,n=39)、8~16细胞组(B2,n=57)和含融合细胞组(B3,n=126);比较各组间的种植率、妊娠率和多胎率。结果A3组妊娠率、种植率(分别为55.17%、34.29%)显著高于A1组(分别为15.22%、6.67%)、A2组(分别为29.17%、16.00%)(P<0.01),且A2组妊娠率、种植率显著高于A1组(P<0.01),A3组多胎率显著高于A2组(36.46%vs.7.14%)(P<0.01),A1组无多胎妊娠;B2组妊娠率显著高于B1组(52.63%vs.27.59%)(P<0.01),B2组种植率显著高于B1组(31.15%vs.10.71%)(P<0.05),而B2组与B3组妊娠率、种植率均无显著差异(P>0.05),三组间多胎率无显著差异(P>0.05),但B3组多胎率有所升高。结论卵裂期冻融胚胎经过夜培养后,有2个及以上生长的胚胎,且卵裂球发育到8~16细胞或有融合细胞阶段者,能获得更好的临床结局;对移植含2个及以上生长的胚胎,可考虑选择单胚胎移植,以降低多胎妊娠。Objective： To explore the impact of the number of grown embryos and the blastomere proliferation after overnight culture in frozen-thawed embryos at cleavage stage on the clinical outcome. Methods： A total of 268 frozen-thawed cycles were analyzed retrospectively. According to the number of grown embryos after overnight culture, the cycles were divided into three groups： no grown embryo group （A1, n=46）; one grown embryo group （A2, n=48） and more than two grown embryos group （A3, n= 174）. According to the proliferation of blastomere, the cycles were divided into three groups： blastomeres〈8-cell group （B1, n=39）, blastomeres 8 to 16-cell group （B2, n=57） and blastomeres compacted group （B3, n=126）. The implantation rate, pregnancy rate and the multiple pregnancy rate were compared among the groups. Results： The pregnancy rate （55.17%） and implantation rate （34.29%） in group A3 were significantly higher than those in group A1 （15.22%, 6.67% respectively） or group A2 （29.17%, 16.00% respectively） （P〈0.01）, and those of group A2 were significantly higher than group A1 （P〈 0.01）. The multiple pregnancy rate in group A3 were significantly higher than that in group A2 （36.46% vs. 7. 14%, P〈0. 01）. There were no multiple pregnancy in group A1. The pregnancy rate （52.63% vs.27.59%, P〈0.01） and the implantation rate（31.15% vs. 10.71%, P〈0.05） in group B2 were significantly higher than those in group B1. The pregnancy rate and implantation rate between group B2 and B3 had no significant differences （P〉0.05）. There was no significant difference in multiple pregnancy rate among group B1, B2, and B3 （P 〉 0.05）, but multiple pregnancy rate was slightly higher in group B3. Conclusions. Frozen-thawed embryos at cleavage stage after overnight culture, which had more than two grown embryos and blastomeres developed to 8 to 16-cell or compaction formed, can obtain better clinical outcomes. Single embryo transfer can be considered for pat

关 键 词：卵裂期胚胎 冻胚移植 过夜培养 种植率 临床妊娠率 多胎率 

分 类 号：R[医药卫生]