不同发育阶段、不同质量囊胚冷冻复苏移植周期妊娠结局分析  

Analysis of pregnancy outcome of blastocysts in different developmental stages and with different quality during cryo-resuscitation and transplantation cycle

作　　者：李澎涛[1] 殷晨星[1] 王娜[1] 邢鹏[1] 孟娜娜 郭战坤[1] LI Peng-tao;YIN Chen-xing;WANG Na;XING Peng;MENG Na-na;GUO Zhan-kun(Department of Reproductive Medicine, Maternal and Child Health Hospital of Baoding City, Hebei Province, Baoding 071000, China)

机构地区：[1]河北省保定市妇幼保健院生殖医学科,河北保定071000

出　　处：《河北医科大学学报》2022年第2期166-172,共7页Journal of Hebei Medical University

基　　金：保定市科技局计划项目(1951ZF084)。

摘　　要：目的分析囊胚的发育阶段及其内细胞团、滋养层质量对妊娠结局的影响,从而为囊胚冷冻时机的把握及冻融胚胎移植(frozen-thawed embryo transfer,FET)周期解冻胚胎选择提供帮助。方法本研究回顾分析了在保定市妇幼保健院生殖医学科接受单囊胚FET周期的患者资料,依据囊胚扩张/孵出状态及囊胚质量将囊胚分为A1组(4期优质囊胚组)、A2(4期非优质囊胚组)、B1组(5期优质囊胚组)、B2组(5期非优质囊胚组)、C1组(6期优质囊胚)、C2组(6期非优质囊胚),比较相同质量不同发育阶段囊胚FET周期妊娠结局的差异,及同一发育阶段不同质量囊胚FET周期妊娠结局差异。结果优质囊胚组间比较,A1组FET周期的妊娠率、着床率显著高于B1组(P<0.05),A1组与C1组FET周期的妊娠率、着床率比较差异无统计学意义(P>0.05),但C1组的妊娠率、着床率有下降趋势,3组间FET周期流产率、活产率、男/女比例、孕周及新生儿体重差异无统计学意义(P>0.05);非优质囊胚组间比较,A2、B2、C23组FET周期妊娠率、着床率、流产率、活产率、男/女比例、孕周及新生儿体重差异无统计学意义(P>0.05);同一阶段不同质量囊胚组间比较,A1组的妊娠率、着床率、活产率显著高于A2组(P<0.05),而流产率、男/女比例、孕周及新生儿体重2组间比较差异无统计学意义(P>0.05),B1组对比B2组及C1组对比C2组FTE的妊娠率、着床率,流产率、活产率、男/女比例、孕周及新生儿体重差异无统计学意义(P>0.05)。结论囊胚的发育阶段对囊胚FET结局有一定的影响,其中4期优质囊胚FET的妊娠率、着床率显著优于5期优质囊胚FET临床结局,与6期优质囊胚ET周期的妊娠率、着床率比较差异无统计学意义,但6期囊胚的妊娠率、着床率有下降趋势;相同发育阶段的4期优质囊胚FET临床结局显著高于4期非优质囊胚FET妊娠率、着床率,因此囊胚FET周期应优先考虑4期优质�Objective To analyze blastocyst development stage and the effects of its inner cell mass and trophoblast quality on pregnancy outcome,so as to provide help for the timing of blastocyst freezing and the selection of thaw embryos during frozen-thawed embryo transfer(FET)cycle.Methods This study retrospectively analyzed the data of patients who received the single blastocyst FET cycle in the Department of Reproductive Medicine,Maternal and Child Health Hospital of Baoding City.According to blastocyst expansion/hatch status and blastocyst quality,blastocysts were divided into A1 group(stage 4 high-quality blastocyst group),A2 group(stage 4 non-high-quality blastocyst group),B1 group(stage 5 high-quality blastocyst group),B2 group(stage 5 non-high-quality blastocyst group),C1 group(stage 6 high-quality blastocyst),and C2 group(stage 6 non-high-quality blastocyst).The difference in pregnancy outcome of FET cycle of blastocysts of the same quality at different developmental stages,and the difference in pregnancy outcome of FET cycle of blastocysts of different quality at the same developmental stage were compared.Results Compared with the high-quality blastocyst groups,the pregnancy rate and implantation rate of the FET cycle in the A1 group were significantly higher than those in the B1 group(P<0.05),while there was no significant difference in the pregnancy rate and implantation rate of the FET cycle between the A1 group and the C1 group(P>0.05).However,the pregnancy rate and implantation rate of the C1 group showed a downward trend,and there was no statistical difference in parameters such as abortion rate,live birth rate,male/female ratio,gestational age,and newborn weight during the FET cycle among the three groups(P>0.05).Compared with non-high-quality blastocyst groups,there was no statistical difference in pregnancy rate,implantation rate,miscarriage rate,live birth rate,male/female ratio,gestational age and newborn weight during FET cycle in A2,B2,and C2 groups(P>0.05).Compared with theblastocyst groups of diff

关 键 词：胚胎移植 囊胚分期 妊娠结局 

分 类 号：R321.3[医药卫生—人体解剖和组织胚胎学]