D5、D6优质囊胚移植和冷冻策略研究  

The strategies in cryopreservation and transfer of high-quality blastocysts on Day5 and Day 6

作　　者：陈清汾 康跃凡[1] 林典梁[1] 杜生荣[1] CHEN Qingfen;KANG Yuefan;LIN Dianliang(Fujian Provincial Maternity and Children’s Hospital,Affiliated Hospital of Fujian Medical University(Fuzhou 350001))

机构地区：[1]福建省妇幼保健院(福建医科大学附属医院)生殖医学中心

出　　处：《陕西医学杂志》2019年第10期1263-1267,1396,共6页Shaanxi Medical Journal

基　　金：福建省卫生计生青年科研课题(2018-1-20)

摘　　要：目的:比较冻融移植周期中不同发育速度(D5或D6)的优质囊胚的妊娠结局,探讨不同发育速度的优质囊胚的移植和冷冻策略。方法:收集行D5或D6冻融优质囊胚移植(≥1个)的周期1864个,女方取卵年龄均<38岁。根据移植囊胚数、囊胚等级和囊胚的发育速度分为D5单优质囊胚组(D5-SHBT,822个移植周期)、D5双优质囊胚组(D5-DHBT,503个移植周期)、优和非优D5囊胚组(D5-H&PBT,116个移植周期)、D6单优质囊胚组(D6-SHBT,210个移植周期)、D6双优质囊胚组(D6-DHBT,94个移植周期)、优和非优D6囊胚组(D6-H&PBT,119个移植周期);比较D5各组冻融囊胚移植周期的妊娠结局、D6各组冻融囊胚移植周期的妊娠结局及D5和D6单、双优质冻融囊胚移植周期的妊娠结局。结果:在D5冻融囊胚移植周期中,各组间流产率比较差异无统计学意义;D5-DHBT临床妊娠率显著高于D5-SHBT,D5-H&PBT临床妊娠率与D5-DHBT、D5-SHBT比较差异均无统计学意义;D5-SHBT种植率显著高于D5-H&PBT,其余两组种植率比较差异均无统计学意义;D5-DHBT和D5-H&PBT多胎率均显著高于D5-SHBT,D5-DHBT和D5-H&PBT多胎率比较差异无统计学意义;D5-DHBT早产率均显著高于D5-H&PBT和D5-SHBT,D5-H&PBT和D5-SHBT早产率比较差异无统计学意义;D5-DHBT活产率显著高于D5-SHBT,其余两组组活产率比较差异无统计学意义。在D6冻融囊胚移植周期中,各组间种植率、流产率和早产率比较,差异均无统计学意义;临床妊娠率、多胎率和活产率组间比较,差异均具有统计学意义,其中D6-DHBT和D6-H&PBT的临床妊娠率、多胎率及活产率均显著高于D6-SHBT,D6-DHBT临床妊娠率、多胎率及活产率和D6-H&PBT比较差异均无统计学意义。D5和D6单、双优质冻融囊胚移植周期中,各组间流产率比较,差异无统计学意义;而种植率、临床妊娠率、多胎率、早产率和活产率组间比较,差异均具有统计学意义,其中D5-DHBT临床妊娠率和活产率均显Objective:The purpose of this study was to compare the pregnancy outcomes of high-quality blastocysts cryopreserved during different developmental stages(frozen-thawed day 5[D5]and day 6[D6]cycles).Our aim was to investigate the strategies into cryopreservation and transplantation of high-quality blastocysts on day 5 and day 6.Methods:Retrospective analysis of the clinical data on 1864 frozen-thawed high-quality blastocyst transfer cycles among day 5 or day 6.The female were all younger than 38 years old.The cycles were stratified as single high-quality blastocyst group of day 5(D5-SHBT,n=822),high and poor quality blastocyst group of day 5(D5-H&PBT,n=116)and double high-quality blastocyst group of day 5(D5-DHBT,n=503),according to the number of blastocyst transfer,the blastocyst grade and development speed.The pregnancy outcomes of frozen-thawed blastocyst transfer cycles among day 5 were compared.Meanwhile,the frozen-thawed high-quality blastocyst transfer cycles among day 6 were also divided into single high-quality blastocyst group of day 6(D6-SHBT,n=210),high and poor quality blastocyst group of day 6(D5-H&PBT,n=119)and double high-quality blastocyst group of day 6(D6-DHBT,n=94).The pregnancy outcome of each group was compared.Finally,we compared the pregnancy outcomes of single and double high-quality blastocyst transfer cycles between day 5 and day 6.Results:There was no significant difference in the abortion rate among the frozen-thawed blastocyst transfer cycles of day 5.The clinical pregnancy rate of the D5-DHBT group was significantly higher than that of the D5-SHBT group.However,the clinical pregnancy rates were not significantly different between the D5-H&PBT group and the D5-DHBT group,nor differ from the D5-H&PBT group to the D5-SHBT group.The implantation rate of the D5-SHBT group was significantly higher than that of the D5-H&PBT group,and there was no significant difference between the other two groups.The multiple pregnancy rates from the D5-DHBT group and the D5-H&PBT group were comparable to

关 键 词：D5囊胚 D6囊胚 妊娠结局 冻融移植周期 

分 类 号：R715[医药卫生—妇产科学]