第3日胚胎质量对冻融囊胚移植周期临床结局的影响  

Effect of day 3 embryo quality on the clinical outcomes of frozen-thawed blastocyst transfer

作　　者：史三宝 朱杰[1] 汪存利[1] 杜馨 何瑞冰[1] 李洋[1] 殷慧群[1] 姜宏[1] ShiSanbao;Zhu Jie;Wang Cunli;Du Xin;He Ruibing;Li Yang;Yin Huiqun;Jiang Hong(Reproductive Medicine Center,the 105th Hospital of PLA,Hefei 230031,China)

机构地区：[1]中国人民解放军第105医院生殖医学中心,合肥230031

出　　处：《中华生殖与避孕杂志》2018年第7期548-552,共5页Chinese Journal of Reproduction and Contraception

基　　金：南京军区医学科技创新重大项目(14ZX06)

摘　　要：目的探讨第3日(D3)胚胎质量对冻融囊胚移植周期(frozen-thawed blastocyst transfer,FBT)临床结局的影响。方法回顾性分析2013年3月—2017年2月在本院生殖中心行冻融双囊胚FBT的1 212个周期的临床资料,按移植囊胚所对应D3胚胎的形态学评分将患者分为双优质卵裂胚移植组、单优质卵裂胚组、无优质卵裂胚组;根据移植囊胚所对应D3胚胎卵囊球分为双8-细胞(8C)组、单8C组及非8C组,比较各组FBT的临床结局。结果 D3双优质卵裂胚组的胚胎种植率(44.7%)、临床妊娠率(68.3%)及活产率(54.9%)均显著高于D3无优卵裂胚组(34.4%、55.4%、41.1%;P=0.003、P=0.008、P=0.022);D3中双8C组的胚胎种植率(48.2%)、临床妊娠率(71.4%)及活产率(58.8%)均显著高于非8C组(40.1%、61.3%、45.2%;P=0.002、P=0.005、P=0.002),但多胎妊娠率(27.9%)明显高于D3非8C组(19.6%)。结论 FBT的临床结局与其对应D3胚胎质量密切相关,D3优质卵裂胚尤其8C源囊胚临床结局更佳;选择D3 8C来源的单囊胚或D3非优质卵裂胚来源的双囊胚移植,可在获得高活产率的同时,减少多胎妊娠率。Objective To investigate the relationship between day 3 （D3） embryo quality and the clinical pregnancy outcomes of frozen-thawed blastocyst transfer （FBT）. Methods The clinical data of 1 212 frozen blastocysts transfer cycles transferred two good-quality blastocysts in our center from March 2013 to February 2017 were analyzed retrospectively. According to the morphological score of D3 cleavage embryos of transferred blastocysts, all enrolled subjects were divided into two good-quality embryo group, single good-quality group and non good-quality embryo groups, and according to the number of blastomeres on D3, they were also divided into two 8C group, single 8C group, non-SC group. The clinical outcomes of FBT were compared among groups. Results The embryo implantation rate （44.7%）, the clinical pregnancy rate （68.3%） and the live birth rate （54.9%） in two good-quality embryo group were significantly higher than those in non good-quality embryo groups （34.4%, 55.4%, 41.1%; P=0.003, P=0.008, P=0.022）. The embryo implantation rate （48.2%）, the clinical pregnancy rate （71.4%） and the live birth rate （58.8%） in two 8C group were significantly higher compared with non-SC group （40.1%, 61.3%, 45.2%; P=0.002, P=0.005, P=0.002）. It was also found that the multiple pregnancy rate （27.9%） in two 8C group was obviously higher than non-SC group （19.6%）. Conclusion The clinical outcomes of FBT is closely related to the morphological score of D3 cleavage embryo, and the blastocyst derived from good-quality cleavage embryo could achieve a better clinical outcome, especially from 8C of D3. Transferring single blastocyst derived from 8C of D3 or two blastocysts derived from non good-quality cleavage embryo may lead to a higher live rate and lower multiple pregnancy rate.

关 键 词：冻融囊胚移植(FBT) 妊娠率 活产率 多胎率 

分 类 号：R714.8[医药卫生—妇产科学]