三种胚胎移植策略在IVF-ET临床应用价值评估  

Effect of three embryo transfer strategies on pregnancy outcomes in woman with IVF-ET

作　　者：段丽[1] 杜丹[1] 刘海鹏[1] 彭姝明[1] 杨帆[1] DUAN Li;DU Dan;LIU Hai-peng;PENG Shu-ming;YANG Fan(Reproductive Medicine Center,Chenzhou First People’s Hospital,Chenzhou 423000)

机构地区：[1]湖南省郴州市第一人民医院生殖医学中心,郴州423000

出　　处：《生殖医学杂志》2020年第11期1427-1432,共6页Journal of Reproductive Medicine

摘　　要：目的评估IVF-ET常用的3种胚胎移植策略的临床结局,以期获得最优化的胚胎移植策略。方法选择2016年1月至2019年6月在我中心接受体外受精或卵胞浆内单精子显微注射受精(IVF/ICSI)治疗的1073周期患者。按年龄将患者分为<35岁组(622周期)和≥35岁组(451周期);各年龄组再根据胚胎移植策略分为双卵裂胚组(移植双优卵裂胚组)、1+1卵裂胚组(移植优+非优双卵裂胚组)和单囊胚组(移植单个优质囊胚组)3个亚组。分别比较各组患者的临床资料和妊娠结局。结果<35岁组患者中,双卵裂胚组、1+1卵裂胚组和单囊胚组的临床妊娠率比较均无显著性差异(P>0.05);单囊胚组的胚胎种植率显著高于双卵裂胚组和1+1卵裂胚组(P<0.05);单囊胚组的多胎妊娠率显著低于双卵裂胚组和1+1卵裂胚组(P<0.05)。≥35岁组患者中,双卵裂胚组、1+1卵裂胚组和单囊胚组的临床妊娠率比较也均无显著性差异(P>0.05);单囊胚组的胚胎种植率显著性高于双卵裂胚组和1+1卵裂胚组(P<0.05);单囊胚组的多胎妊娠率显著低于双卵裂胚组和1+1卵裂胚组(P<0.05);1+1卵裂胚组的多胎妊娠率也显著低于双卵裂胚组(P<0.05)。结论选择性单个优质囊胚移植是目前胚胎移植最优策略;当患者年龄≥35岁时,优+非优双卵裂胚移植也是一种可行的胚胎移植策略。Objective:To investigate the effect of three embryo transfer strategies on the pregnancy outcome of IVF-ET.Methods:A retrospective study was conducted on the women with IVF-ET in our reproductive center from January 2016 to June 2019.A total of 1073 patients were included in the study and were divided into two groups:age<35 group(n=622)and age≥35 group(n=451).Based on the embryo transfer strategy,each age group was divided into three subgroups:group A(transfer double good cleavage embryo group),group B(transfer one good+one non-good cleavage embryo group)and group C(transfer a single good-quality blastocyst group).The clinical data and the pregnancy outcome were compared among the groups.Results:In the patients aged<35 years,there was no significantly difference in clinical pregnancy rate among the three subgroups(P>0.05).Compared with group A and group B,embryo implantation rate was significantly higher in group C(P<0.05),and multiple pregnancy rate was significantly lower in group C(P<0.05).In patients aged≥35 years,no significant difference was found in clinical pregnancy rate among the three subgroups(P>0.05).Compared with group A and group B,embryo implantation rate was significantly higher in group C(P<0.05),and multiple pregnancy rate was significantly lower in group C(P<0.05).Multiple pregnancy rates in group B were also significantly lower than group A(P<0.05).Conclusions:Single good quality blastocyst transfer would be the best strategy for IVF-ET.In patients aged≥35 years,one good quality cleavage embryo plus one non-good quality cleavage embryo transfer would also be a feasible strategy for IVF-ET.

关 键 词：胚胎移植策略 体外受精-胚胎移植 临床结局 

分 类 号：R711.6[医药卫生—妇产科学]