高龄冻融单囊胚和双囊胚移植后出生结局的比较  

Comparison of neonatal outcome in old women for frozen-thawed single blastocyst or double blastocysts transfer

作　　者：李彩虹[1] 程东凯[1] 于洪君[1] 孙晓玲[1] 刘吉[1] 李春义[1] 李宝山[1] 许蓬[1] 

机构地区：[1]沈阳东方医疗集团菁华医院,沈阳辽宁110005

出　　处：《中国优生与遗传杂志》2017年第2期114-116,122,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的比较冻融单囊胚和双囊胚移植后的临床妊娠结局及新生儿状况。方法回顾性分析2012年1月-2014年12月在沈阳东方医疗集团菁华医院生殖中心进行冻融囊胚移植的5286个周期,按照移植囊胚数分为两组:单囊胚组3007例,双囊胚组2279例,分别比较单囊胚组与双囊胚组的临床妊娠率、种植率、流产率、异位妊娠率、多胎率、早产率、低出生体重(LBW)率、新生儿男女比例、出生缺陷等指标;之后对年龄>35岁亚组单独分析,分为单囊胚和双囊胚组并比较两组间上述指标是否有差异。结果单囊胚组临床妊娠率、多胎率、活产率、早产率和LBW率显著低于双囊胚组,种植率单囊胚组显著高于双囊胚组(P<0.05);其余指标两组间无显著差异(P>0.05)。年龄>35岁亚组中单囊胚组种植率显著高于双囊胚组,单囊胚组早产率和LBW率显著低于双囊胚组(P<0.05),双囊胚组多胎发生率26.8%,单囊胚组无多胎妊娠;其余指标两组间无显著差异(P>0.05)。结论不分年龄段比较冻融囊胚移植周期单囊胚移植和双囊胚移植的妊娠及新生儿结局,认为单囊胚移植结局优于双囊胚组,不仅种植率高且多胎、早产、LBW发生率低;尤其对于高龄患者,更应该主张单囊胚移植,双囊胚移植不仅未显著提高妊娠率且妊娠并发症的发生率增加。Objective：To compare the birth outcomes and neonatal status of frozen thawed blastocysts with different number. Methods：5286 cycles of thawed blastocysts transferred in January 2012 to December 2014 were retrospectively analyzed.They were divided into two groups according to the number of embryos transferred：single blastocyst transferred（n=3007）,double blastocysts transferred（n=2279）.We compared clinical pregnancy rate,implantation rate,abortion rate,ectopic pregnancy rate,multiple pregnancy rate,premature delivery rate,low birth weight（LBW）rate,newborn sex,birth defects and so on. Then in age35 subgroup,they were also divided into single and double groups and compared whether there were any differences of the above indexes between the two groups. Results：Compared with double blastocysts group,there were lower clinical pregnancy rate,multiple pregnancy rate,live birth rate,premature delivery rate and LBW rate in single blastocyst group（P〈0.05）,but the implantation rate of single blastocyst group was higher than the double group,No significant differences were detected in other index. In age〉35 subgroups,implantation rate of the single blastocyst group is significantly higher than double,LBW rate was significantly lower than the double blastocyst group（P〈0.05）,the multiple pregnancy rate of double blastocyst group was 26.8%,there were no significant differences of the rest indicators between the two groups（P〉0.05）. Conclusion：To compare the birth outcomes and neonatal status of frozen thawed blastocysts with differnent numbers,we think single blastocyst transplant outcome is better than double blastocysts,with high implantation rate,low multiple pregnancy rate,premature delivery rate and LBW rate;Especially for old patients,it should be advocated for single blastocyst transfer,double blastocysts transplant not only did not significantly increase pregnancy rate but also increase the incidence of pregnancy complications.

关 键 词：冻融囊胚移植 妊娠结局 出生结局 

分 类 号：R714.8[医药卫生—妇产科学]