囊胚质量对冻融胚胎移植临床结局的影响及囊胚移植选择策略  

Effect of blastocyst quality on clinical results of frozen-thawed embryo transfer and strategy of blastocyst transfer

作　　者：李明颖[1] 马艳萍[1] 高梦莹[1] 邓波[1] 邓莲[1] 相立峰[1] 李永刚[1] LI Mingying;MA Yanping;GAO Mengying;DENG Bo;DENG Lian;XIANG Lifeng;LI Yonggang(Department of Reproductive Medicine,First People′s Hospital of Yunnan Province,Kunming 650032,China)

机构地区：[1]云南省第一人民医院生殖医学科,昆明650032

出　　处：《实用医学杂志》2018年第15期2453-2456,共4页The Journal of Practical Medicine

基　　金：云南省卫生科技计划基金资助项目(编号:2016NS213)

摘　　要：目的探讨冻融囊胚移植中囊胚质量对临床结局的影响,以及最优的囊胚移植选择策略。方法本研究共包括2 054个囊胚冻融移植周期,将行囊胚冻融移植的患者根据移植囊胚的数量和质量进行分组,不同组之间年龄差异使用独立样本t检验分析;其余临床指标(不孕原因、促排方案、授精方案、临床妊娠率、种植率、活产率、多胎率)使用Χ~2检验分析。结果相对于卵裂期胚胎移植,移植单个优质囊胚可以显著提高临床妊娠率(42.31%/28.89%)、种植率(42.31%/17.93%)和活产率(29.96%/21.17%),同时显著降低多胎率(1.85%/24.68%)。相对于不分质量的双囊胚移植,移植单个优质囊胚移植可以显著改善种植率(42.31%/37.95%),并极大地降低多胎率(1.85%/39.79%)。随着移植胚胎中低质量囊胚数目的增加,其妊娠率(60.63%～35.79%)、种植率(44.01%～22.37%)、活产率(44.01%～26.84%)逐渐下降。结论低质量囊胚对冻融胚胎移植的临床结局有负面影响,移植单个优质囊胚可以获得较理想的临床结局。Objective The final purpose of assisted reproduction technology(ART)is the birth of single healthy baby.This research discussed the effect of blastocyst quality on clinical results of FET and strategy of blastocyst transfer.Methods A cohort of 2 054 blastocyst thaw transfer cycles was conducted.Patients were divided into groups according to number and quality of blastocysts transferred.Independent t-tests were used to analyze differences of age in different groups,and c2 tests were used to analyze the other assessments of clinical outcomes.Results In contrast to cleavage embryo transfer,single high?quality blastocyst transfer could lead to higher pregnant rate(42.31%/28.89%),implantation rate(42.31%/17.93%)and live birth rate(29.96%/21.17%),with a much lower multiple gestations rate(1.85%/24.68%);Single highquality blastocyst transfer improved implantation rate(42.31%/37.95%)while sharply decreased multiple gestations rate(1.85%/39.79%)compared with double blastocyst transfer;The pregnancy rate(60.63%~35.79%),implantation rate(44.01%~22.37%),live birth rate(44.01%~26.84%)decreased as the number of lowquality blastocysts increased.Conclusions Lowquality blastocysts have negative influence on clinical results of FET.In a summary,transfer of single highquality blastocyst can achieve optimal clinical results with the lowest multiple gestations rate.

关 键 词：囊胚质量 冻融移植 临床结局 囊胚移植策略 

分 类 号：R714.8[医药卫生—妇产科学]