授精第3天4~5-细胞胚胎的利用价值  

Utilization Value of 4-to 5-Cell Embryos on the Third Day of Insemination

作　　者：宋冰冰 呼琳[1] 郝好英[1] 贾楠[1] 李昊雨 殷宝莉[1] SONG Bing-bing;HU Lin;HAO Hao-ying;JIA Nan;LI Hao-yu;YIN Bao-li(The Reproductive Medicine Center,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院生殖医学研究所,河南郑州450003

出　　处：《河南医学研究》2020年第22期4044-4046,共3页Henan Medical Research

基　　金：河南省科技攻关项目(182102310274)。

摘　　要：目的探讨授精第3天4~5-细胞胚胎的利用价值。方法回顾性分析2017年1月至2018年12月河南省人民医院生殖医学研究所489例接受冻融移植(FET)助孕患者的资料。依据胚胎移植个数和胚胎发育情况将患者分为A组(移植1枚4~5-细胞胚胎,29例)、B组(移植2枚4~5-细胞胚胎,34例)、C组(移植1枚4~5-细胞胚胎和1枚优质卵裂期胚胎,156例)、D组(移植1枚优质卵裂期胚胎,211例)和E组(移植1枚冷冻复苏的囊胚,来源于新鲜周期4~5-细胞胚胎的体外延长培养,59例)。比较5组患者的着床率、临床妊娠率、早期流产率和分娩率。结果E组着床率高于A组、B组、C组和D组,D组着床率高于A组和B组(均P<0.05)。E组临床妊娠率高于A组、B组和D组,C组和D组的临床妊娠率均高于A组(均P<0.05)。5组早期流产率比较,差异无统计学意义(P>0.05)。E组分娩率高于A组、B组和D组,C组分娩率高于A组和D组(均P<0.05)。结论授精第3天4~5-细胞胚胎依然具有不同程度的发育潜能,是具有利用价值的。针对授精第3天4~5-细胞胚胎可以通过新鲜周期行囊胚培养、冷冻复苏获得较好的临床结局。Objective To explore the utilization value of 4-to 5-cell embryos on the third day of insemination.Methods The data of 489 cases of frozen-thawed embryo transfer(FET)-assisted pregnancy cycles from January 2017 to December 2018 in the Reproductive Medicine Center of Henan Provincial People’s Hospital were analyzed retrospectively.According to the number of embryos transferred and the development of embryos,the patients were divided into group A(transplanted one 4-to 5-cell embryo,29 cases),group B(transplanted two 4-to 5-cell embryos,34 cases),group C(transplanted one 4-to 5-cell embryo and one high-quality cleavage stage embryo,156 cases),group D(transplanted one high-quality cleavage stage embryo,211 cases)and group E(transplanted one cryopreserved blastocyst from in vitro extended culture of 4-to 5-cell embryo in fresh cycle,59 cases).The implantation rate,clinical pregnancy rate,early abortion rate and delivery rate of the five groups were compared.Results The implantation rate of patients in group E was higher than that in group A,group B,group C and group D,while that in group D was higher than that in group A and group B(all P<0.05).The clinical pregnancy rate of patients in group E was higher than that in group A,group B and group D,while that in group C and group D was higher than that in group A(all P<0.05).There was no statistical difference in early abortion rate among the five groups(P>0.05).The delivery rate of patients in group E was higher than that in group A,group B and group D,while that in group C was higher than that in group A and group D(all P<0.05).Conclusion On the third day of insemination,4-to 5-cell embryos still have varying degrees of development potential,which are valuable for utilization.For 4-to 5-cell embryos on the third day of insemination,blastocyst culture and cryoresuscitation could be carried out in a fresh cycle to obtain a better clinical outcome.

关 键 词：胚胎 着床率 临床妊娠率 早期流产率 分娩率 

分 类 号：R711.6[医药卫生—妇产科学]