体外受精周期不同获卵数的移植策略  

The Fresh Embryo Transfer Strategy of in Vitro Fertilization

作　　者：胡文惠 张红琴 钟影 HU Wenhui;ZHANG Hongqin;ZHONG Ying(Chengdu Jinjiang District Maternal and Child Health Care of reproductive center,Chengdu Sichuang 610016,China)

机构地区：[1]成都市锦江妇幼保健院生殖中心,四川成都610016

出　　处：《实用妇产科杂志》2021年第12期955-958,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨体外受精周期不同获卵数胚胎移植策略。方法:采用回顾性分析方法,2018年10月至2019年9月在成都市锦江区妇幼保健院生殖中心行体外受精-胚胎移植2756个周期,按获卵数分为5组(A组获卵数≤5枚,B组获卵数6~9枚,C组获卵数10~14枚,D组获卵数15~19枚,E组获卵数≥20枚),比较5组之间全胚冷冻率、取消周期率及新鲜胚胎移植率;分析每组卵裂期移植与囊胚期移植的临床妊娠率和种植率。结果:(1)全胚冷冻率5组之间两两相比差异有统计学意义;取消周期率E组与其他4组相比具差异有统计学意义,其他4组之间比较差异无统计学意义;新鲜胚胎移植率D组、E组与其他3组两两相比差异有统计学意义。(2)卵裂期优胚率A组最高(44.38%)与其他4组比较差异有统计学意义;囊胚形成率E组最高(63.50%),与其他各组比较分别差异有统计学意义;(3)临床结局比较:临床妊娠率比较,囊胚期移植与卵裂期移植5组均差异无统计学意义;种植率比较,B组和C组囊胚期移植显著高于卵裂期移植,差异有统计学意义;其他组的种植率差异无统计学意义。结论:获卵数≥15枚,养囊胚全胚冷冻,患者更获益;获卵的种植率数在6~14枚,选择囊胚期移植有更好的临床结局;获卵数≤5枚,选择卵裂期移植对患者更有益。Objective:To discuss the fresh embryo transfer strategy of in vitro fertilization(IVF).Methods:A retrospective study was applied including 2756 IVF cycles from October 2018 to September 2019 in chengdu,Jinjiang District Maternal and Child Health Care of reproductive center.Patients were divided to five groups according number of eggs collected(Group 1:≤ 5 eggs,Group 2:6-9 eggs,Group 3:10-14 eggs,Group 4:15-19 eggs,Group 5≥ 20 eggs).The main parameters were freeze-all rate,cancellation rate,and fresh transfer rate.The clinical pregnancy rate and implantation rate of cleveage and blastocyst stage transfer cycles were also analyzed.Results:There were statistically significant differences in the freeze-all rate among five groups.The cancellation rate of the Group 1 was much lower while the other four groups showed no differences.Compared to the other three groups,the rate of fresh embryo transfer was statistically different in group B as well as group 1.The rate of excellent embryos in cleavage stage was the highest in Group A(44.38%),which was significantly different from the other four groups;The blastocyst formation rate of group E was the highest(63.50%)compared with other groups.The stage of embryo had no impact on clinical pregnancy rate in any of the 5 groups.However,transfer of blastocyst stage embryos showed a higher implantation rate than cleveage stage embryos in group 2 and group 3,which was statistically significant.Conclusions:In order to prevent ovarian hyperstimulation syndrome,a freeze-all strategy is recommended when more than 15 eggs were collected.When 6 to 14 eggs were retrieved,transfer of blastocyst embryos could achieve a better clinical outcome than cleveage stage embryos.On the contrary,the cleavage stage transfer seems to be a better choice for patients who harvest less than 5 eggs.

关 键 词：体外受精 新鲜胚胎移植 全胚冷冻 卵裂期胚胎 囊胚 

分 类 号：R714.13[医药卫生—妇产科学]