冻融胚胎过夜培养后生长融合状况对妊娠结局的影响  

Effect of growth and fusion status of frozen-thawed embryos after overnight culture on pregnancy outcome

作　　者：路新乐 黄鲜菊 史昊 韩潇 毕钡钡 崔秋盈 胡琳莉[1] LU Xin-le;HUANG Xian-ju;SHI Hao;HAN Xiao;BI Bei-bei;CUI Qiu-ying;HU Lin-li(Reproductive Medicine Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院生殖医学中心,郑州450052

出　　处：《生殖医学杂志》2022年第2期143-149,共7页Journal of Reproductive Medicine

基　　金：国家重点基础研究发展计划(2019YFA0110903)。

摘　　要：目的探讨冻融胚胎经过夜培养后,胚胎卵裂球的生长及融合状况对妊娠结局的影响。方法回顾性分析2019年1月至2020年4月于郑州大学第一附属医院生殖中心行冻融胚胎移植(FET)助孕治疗的2064例患者(共2064个周期)的临床资料。根据移植胚胎数目不同分为移植1枚胚胎组(单胚组)和移植两枚胚胎组(双胚组);根据过夜培养后胚胎是否分裂生长将单胚组分为单胚生长组(601个周期)和单胚无生长组(185个周期);将双胚组分为双胚生长组(1175个周期)和双胚无生长组(103个周期)。再根据胚胎是否有融合将单胚生长组和双胚生长组分别分为两个亚组:单胚生长融合组(395个周期)和单胚生长无融合组(206个周期),双胚生长融合组(889个周期)和双胚生长无融合组(286个周期)。比较各组患者一般情况和妊娠结局的差异,并应用Logistic回归分析探讨影响临床妊娠率和流产率的因素。结果单胚组中,单胚生长组的临床妊娠率(35.77%vs.16.76%)、活产率(26.96%vs.10.81%)显著高于单胚无生长组(P<0.05);单胚生长融合组的临床妊娠率(42.78%vs.22.33%)、活产率(32.41%vs.16.50%)显著高于单胚生长无融合组(P<0.05)。双胚组中,双胚生长组的临床妊娠率(61.45%vs.26.21%)、活产率(50.21%vs.19.42%)显著高于双胚无生长组(P<0.05);双胚生长融合组的临床妊娠率(64.34%vs.52.45%)、多胎率(37.59%vs.22.67%)、活产率(52.98%vs.41.61%)均显著高于双胚生长无融合组(P<0.05)。双胚生长融合组的临床妊娠率、多胎率及活产率均显著高于单胚生长融合组,异位妊娠率显著低于单胚生长融合组(P<0.05)。Logistic回归分析显示,胚胎分裂生长[OR=2.599,95%CI(1.829,3.693)]、胚胎融合[OR=1.790,95%CI(1.436,2.231)]及移植胚胎数[OR=2.176,95%CI(1.774,2.671)]与临床妊娠率呈正相关(P<0.05);年龄与临床妊娠率[OR=0.907,95%CI(0.890,0.925)]呈负相关(P<0.05),与流产率[OR=1.134,95%CI(1.092,1.178)]呈正相关(P<0.0Objective:To explore the effects of growth and fusion status of blastomeres on pregnancy outcome after frozen-thawed embryos were cultured overnight.Methods:The clinical data of 2064 patients(2064 cycles)undergone frozen-thawed embryo transfer(FET)in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2019 to April 2020 were analyzed.According to the number of embryos transferred,the cycles were divided into single embryo transfer group(single embryo group)and double embryo transfer group(double embryo group).According to whether the embryo divided and grew after overnight culture,the single embryo group was divided into single embryo growth group(601 cycles)and single embryo non-growth group(185 cycles),and the double embryo group was divided into double embryo growth group(1175 cycles)and double embryo non-growth group(103 cycles).Then,according to whether there was embryo fusion,the single embryo growth group and double embryo growth group were separately divided into two subgroups:single embryo growth fusion group(395 cycles)and single embryo growth non-fusion group(206 cycles),double embryo growth fusion group(889 cycles)and double embryo growth non-fusion group(286 cycles).The general status and the pregnancy outcome were compared among the groups.Logistic regression analysis was used to analyze the factors affecting clinical pregnancy rate and abortion rate.Results:In the single embryo group,the clinical pregnancy rate(35.77%vs.16.76%)and live birth rate(26.96%vs.10.81%)of the single embryo growth group were significantly higher than those of single embryo non-growth group(P<0.05),and the clinical pregnancy rate(42.78%vs.22.33%)and live birth rate(32.41%vs.16.50%)of the single embryo growth fusion group were significantly higher than those of single embryo growth non-fusion group(P<0.05).In the double embryo group,the clinical pregnancy rate(61.45%vs.26.21%)and live birth rate(50.21%vs.19.42%)of the double embryo growth group were significantly higher than

关 键 词：冻融胚胎移植 玻璃化冷冻 胚胎培养 卵裂球 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]