剩余胚胎来源的囊胚冻融移植周期临床结局分析  

Clinical outcome of blastocysts derived from surplus embryos

作　　者：邹敏 李姣 邵淑敏 胡廉[2] 张洁[1] 张玲[2] ZOU Min;LI Jiao;SHAO Shu-min;HULian;ZHANG Jie;ZHANG Ling(Center For Reproductive Medicine,Tong Ji Medical College,Huazhong University of Science Technology,Wuhan 430010;Family Planning Research Institute/Center For Reproductive Medicine,Tong Ji Medical College,Huazhong University of Science ＆ Technology,Wuhan 430010)

机构地区：[1]华中科技大学同济医学院生殖医学中心,武汉430010 [2]华中科技大学同济医学院计划生育研究所/生殖医学中心,武汉430010

出　　处：《生殖医学杂志》2018年第11期1074-1079,共6页Journal of Reproductive Medicine

摘　　要：目的探究IVF/ICSI新鲜周期D3移植和/或冷冻后剩余胚胎形成的囊胚的发育潜能,为临床囊胚培养策略及冻融移植周期胚胎选择提供数据支持。方法回顾性分析本中心2015年1月至2017年12月三年间年龄<36岁患者共993个冻融移植周期的临床资料。比较分析新鲜周期D3移植和/或冷冻后剩余的胚胎继续培养形成的D5囊胚、D6囊胚与D3优质卵裂期胚胎在冻融移植周期中的种植率、临床妊娠率、早期流产率等指标。结果剩余胚胎继续培养的囊胚形成率53.75%、可利用囊胚率67.54%,冻融周期移植囊胚妊娠率62.54%;D5囊胚组的妊娠率(70.93%)和种植率(52.55%)显著高于D6囊胚组(分别为49.55%、34.43%)和D3优质卵裂期胚胎组(分别为55.49%、36.75%)(P<0.05),而D6囊胚组与D3优质卵裂期胚胎组之间妊娠率和种植率无统计学差异(P>0.05);三组间早期流产率无统计学差异(P>0.05)。结论新鲜周期D3移植和/或冷冻后剩余的胚胎继续培养,可获得良好的囊胚形成率;所形成的囊胚在冻融移植周期中也可获得一定的妊娠结局,尤其是D5的囊胚,提高了胚胎的利用率;冻融周期可首选D5囊胚进行复苏移植,利于在最少的移植周期获得妊娠。Objective： To investigate the developmental potential of blastocysts derived from surplus embryos after being transferred and/or vitrified on Day 3, in order to provide data for embryonic culture tactics and embryos selection for transfer in frozen thawed cycle. Methods： The study was a retrospective analysis of the clinical outcome of the transfer with Day 5 Day 6 blastocysts derived from surplus embryos or with Day 3 good quality cleavage stage embryos in frozen thawed cycles of the patients aged less than 36 years. It included 993 frozen thawed cycles in our reproductive center from January 2015 to December 2017. The implantation rates, pregnancy rates, and miscarriage rates were compared among the three groups. Results： The blastocyst formation rate was 53.75%, the blastocyst available rate 67.54% and the blastocyst pregnancy rate 62.54% for the surplus embryos. The pregnancy rate（70.93%）and implantation rate（52.55%）in the patients transferred with Day 5 blastocysts were significantly higher than those with Day 6 blastocysts（49.55%,34. 43%）or Day 3 good quality cleavage embryos（55.49%,36.75%）in frozen thawed cycle（P〈0.05）, but there was no significant difference between Day 6 and Day 3 group（P〉0.05）.There was no significant difference in miscarriage rate among the three groups（P〉0. 05）. Conclusions： The blastocyst formation rate is high by culturing the surplus embryos after being transferred and/or vitrified on Day 3. The clinic outcome is also good, especially in the Day 5 blastocysts group. The embryo available rate can be greatly improved. During the frozen thawed cycle, Day 5 blastocysts can be selected for transplantation, which is beneficial for obtaining pregnancy in the least transplantation cycle.

关 键 词：D5/D6囊胚 剩余胚胎 临床结局 冻融移植周期 

分 类 号：R714.8[医药卫生—妇产科学]