不同冻融胚胎移植策略对临床结局的影响  

Effect of different blastocyst transfer strategies on pregnancy outcomes in frozen-thawed blastocyst transfer cycle

作　　者：彭姝明[1] 刘海鹏[1] 李苏萍[1] 杨帆[1] 段丽[1] PENG Shu-ming;LIU Hai-peng;LI Su-ping;YANG Fan;DUAN Li(Reproductive Medicine Center,Chen zhou First People’s Hospital,Chenzhou 423000)

机构地区：[1]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》2021年第9期1141-1145,共5页Journal of Reproductive Medicine

基　　金：郴州市第一人民医院科技资助计划项目(CZSY2019-060)。

摘　　要：目的比较4种不同冻融胚胎移植(FET)策略对临床结局的影响。方法选取2015年1月至2020年4月在我中心行FET的1549个周期的患者作为研究对象,按照移植囊胚数量和质量的不同分为4组:优质单囊胚组(n=818)、优+非优质双囊胚组(n=286)、非优质双囊胚组(n=232)和优质双囊胚组(n=213),又按照患者年龄分为2个年龄段(<36岁和≥36岁),比较不同年龄段中各组患者的一般情况及临床结局。结果各组患者一般情况比较均无显著差异(P>0.05)。在<36岁患者群体中,4组间的临床妊娠率、流产率和活产率比较均无显著差异(P>0.05);优质单囊胚组的胚胎种植率显著高于其余3组(P<0.05),多胎妊娠率显著性低于其它各组(P<0.05)。在≥36岁患者群体中,优+非优质双囊胚组的临床妊娠率(63.3%vs.51.9%)和活产率(51.9%vs.41.5%)均显著高于优质单囊胚组(P<0.05);与优质双囊胚组比较,优+非优质双囊胚组的临床妊娠率和活产率均无显著差异(P>0.05),而多胎妊娠率显著降低(16.0%vs.32.5%)(P<0.05)。结论患者年龄<36岁时,单个优质囊胚移植可以获取最佳的临床结局;患者年龄≥36岁时,优+非优质双囊胚移植则能获得更好的临床结局。Objective:To compare the effect of four blastocyst transfer strategies on the outcome of pregnancy in frozen-thawed transfer cycles.Methods:A retrospective study was conducted on women undergone frozen-thawed blastocyst transfer(1529 cycles)in our reproductive center from January 2015 to April 2020.The cycles were divided into four groups:single good-quality blastocyst transfer group(n=818);one good-quality blastocyst+one non-good quality blastocyst transfer group(n=286);double non-good quality blastocyst transfer group(n=232);double good-quality blastocysts transfer group(n=213).Moreover the patients were further divided into two subgroups according to the age:age<36 group and age≥36 group.The basic clinical feathers and pregnancy outcome were compared among the four groups.Results:There were no significant differences in basic clinical feathers among the four groups(P>0.05).When the patients aged<36 years,clinical pregnancy rate,miscarriage rate and live birth rate were not significantly different among four groups(P<0.05).The implantation rate of single good-quality blastocyst group was significantly higher than that of the other three groups(P<0.05),while the multiple pregnancy rate was significantly lower than that of other groups(P<0.05).When patients aged≥36 years,the clinical pregnancy rate and live birth rate of one good quality blastocyst+one non-good quality blastocyst group were significantly higher than those of single good-quality blastocyst group[(63.3%vs.51.9%),(51.9%vs.41.5%),P<0.05].Compared with double good-quality blastocysts transfer group,the clinical pregnancy rate and live birth rate in one good quality blastocyst+one non-good quality blastocyst group were not significantly different(P>0.05),but the multi-pregnancy were significantly decreased[(16.0%vs.32.5%),P<0.05].Conclusions:When patients aged<36 years,single good-quality blastocyst transfer can obtain the best clinical outcome for frozen-thawed blastocyst transfer.When patients aged≥36 years,one good-quality+one non-good-quality

关 键 词：冻融囊胚移植 临床结局 优质囊胚 移植策略 

分 类 号：R711.6[医药卫生—妇产科学]