高龄患者冻融囊胚移植策略的比较研究  

Comparative study of frozen-thawed blastocyst transfer strategies in elderly patients

作　　者：李苏萍[1] 刘海鹏[1] 彭姝明[1] 杨帆[1] 段丽[1] LI Su-ping;LIU Hai-peng;PENG Shu-ming;YANG Fan;DUAN Li(Reproductive Medicine Center,Chenzhou 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10期1312-1316,共5页Journal of Reproductive Medicine

摘　　要：目的通过比较不同年龄段高龄患者应用冻融单囊胚移植和冻融双囊胚移植的妊娠结局,以期为高龄患者冻融囊胚移植策略的选择提供参考。方法回顾性分析2015年1月至2020年1月在我院生殖医学中心行冻融囊胚移植、年龄≥35岁患者的临床资料(共954个周期),根据患者年龄不同将纳入对象分为3组:35~37岁组(n=411)、38~40岁组(n=298)和>40岁组(n=245);再依照冻融囊胚的移植数目将每组分为2个亚组:单囊胚移植组(SBT组)和双囊胚移植组(DBT组)。分别比较各年龄段SBT组与DBT组患者的临床结局。结果不同年龄段中SBT组及DBT组患者的囊胚复苏率、优质囊胚率及移植D5/D6囊胚比例均无显著性差异(P>0.05);各组患者的基础FSH(bFSH)水平、移植日内膜厚度和体质量指数(BMI)比较均无显著性差异(P>0.05)。年龄≤40岁患者中SBT组的胚胎种植率显著高于DBT组(35~37岁组中68.50%vs.49.36%,38~40岁组中56.45%vs.37.50%,P<0.05),临床妊娠率和活产率无显著性差异(P>0.05)。35~37岁患者中SBT组的多胎妊娠率显著低于DBT组(2.96%vs 43.52%,P<0.05)。年龄>40岁患者中SBT组的临床妊娠率(43.62%vs.56.95%)和活产率(37.23%vs.50.33%)均显著低于DBT组(P<0.05)。结论对于年龄≤40岁的患者单个冻融囊胚移植为最佳的胚胎移植策略;而对于>40岁的患者可以考虑冻融双囊胚移植,虽然多胎妊娠风险增高,但活产率也明显增高。Objective:To compare the pregnancy outcomes of single and double frozen-thawed blastocyst transplantation in different age groups of elderly patients,in order to provide reference for the selection the strategy of frozen-thawed blastocyst transplantation for them.Methods:A retrospective study was conducted on women aged≥35 who underwent frozen-thawed blastocyst transfer in our reproductive center from January 2015 to January 2020.A total of 954 cycles were included in the study and divided into three groups:35-37 years group(n=411),38-40 years group(n=298)and>40 years group(n=245)according to the age of women.Each group was divided into two subgroups according to the number of frozen-thawed blastocysts:single frozen-thawed blastocyst transfer(SBT group)and double frozen-thawed blastocyst transfer(DBT group).The basic clinical pregnancy outcomes were compared between the SBT and DBT group.Results:There were no significant differences in the blastocyst recovery rate,good-quality blastocyst rate and ratio of Day 5/Day 6 blastocyst between the SBT and DBT group(P>0.05).There were no significant differences in basic FSH(bFSH)level,endometrial thickness on transplantation day and body mass index(BMI)among the groups(P>0.05).When women aged≤40 years,the embryo implantation rate in SBT group was significantly higher than that in DBT group(68.50%vs.49.36%in 35-37 years group,56.45%vs.37.50%in 38-40 years group,P<0.05).There were also no significant differences in clinical pregnancy rate and live birth rate(P>0.05).The multiple pregnancy rate in SBT group aged 35-37 years was significantly lower than that in DBT group(2.96%vs.43.52%,P<0.05).The clinical pregnancy rate(43.62%vs.56.95%)and live birth rate(37.23%vs.50.33%)in SBT group aged>40 years were significantly lower than those in DBT group(P<0.05).Conclusions:Single frozen-thawed blastocyst transplantation is the optimal strategy for the women aged≤40 years.Double frozen-thawed blastocyst transplantation can be considered for the women aged>40 years,although the

关 键 词：高龄患者 冻融囊胚移植 临床结局 

分 类 号：R711.6[医药卫生—妇产科学]