D6非优质冻融囊胚移植策略的探讨  

Exploration of non-high-quality D6 frozen-thawed blastocyst transfer strategy

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,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》2022年第3期309-314,共6页Journal of Reproductive Medicine

摘　　要：目的比较第6天(D6)非优质冻融囊胚移植与第3天(D3)优质冻融双卵裂胚移植方案的临床结局。方法回顾性分析2016年9月至2020年7月于我中心行冻融胚胎移植共803个周期的临床资料,根据患者年龄分为年龄<36岁组(n=429)和年龄≥36岁组(n=374);各年龄段患者再根据不同的胚胎移植策略分为3组:移植D3优质冻融双卵裂胚的为A组,移植D6非优质冻融单囊胚的为B组,移植D6非优质冻融双囊胚的为C组,比较不同年龄段各组间患者的一般资料、胚胎复苏率和临床妊娠结局。结果同年龄段中各组间平均年龄、基础FSH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),A组人工周期占比显著低于B组和C组(P<0.05)。在<36岁年龄段中,各组间胚胎复苏率、临床妊娠率、流产率和活产率比较均无显著性差异(P>0.05),而B组和C组的胚胎种植率均显著高于A组(P<0.05),B组的多胎妊娠率显著低于A组和C组(P<0.05);在≥36岁年龄段中,各组间胚胎复苏率比较也均无显著性差异(P>0.05),A组和C组的临床妊娠率、活产率均显著高于B组(P<0.05),A组和C组的胚胎种植率显著低于B组(P<0.05),但C组的多胎妊娠率显著高于A组和B组(P<0.05)。结论在未能获取优质囊胚时,对于年龄<36岁患者来说,可首选D6非优质冻融单囊胚移植;对于年龄≥36岁高龄患者来说,D3优质冻融双卵裂胚移植策略能够获得更好的临床结局。Objective:To compare the clinical outcomes between non-high-quality D6 frozen-thawed blastocyst transfer and double good-quality D3 cleavage embryo frozen-thawed transfer.Methods:A retrospective study was conducted on 803 cycles of frozen-thawed embryo transfer cycles in our reproductive center from September 2016 to July 2020.The patients were divided into age<36 years old group(n=429)and age≥36 years old group(n=374).The patients of different ages were subdivided into three groups according to different embryo transfer strategies:group A was transplanted with double D3 high-quality frozen-thawed cleavage embryo,group B was transplanted with single D6 non-high-quality frozen-thawed blastocysts,and group C was transplanted with double D6 non-high-quality frozen-thawed blastocysts.The basic clinical data,embryo recovery rate and pregnancy outcome were compared among the three groups.Results:There was no significant difference in mean age,basal FSH level,endometrial thickness and body mass index(BMI)in the different ages groups(P>0.05),but the proportion of artificial cycles in group A was significantly lower than that in group B and C(P<0.05).In the groups age<36 years old,there was no significant difference in embryo recovery rate,clinical pregnancy rate,abortion rate and live birth rate among subgroups(P>0.05),while the embryo implantation rate in group B and C was significantly higher than that in group A(P<0.05),and the multiple pregnancy rate in group B was significantly lower than that in group A and C(P<0.05).In the group age≥36 years old,there was no significant difference in embryo recovery rate among the subgroups(P>0.05).The clinical pregnancy rate and live birth rate of group A and C were significantly higher than those of group B(P<0.05).The embryo implantation rate of group A and group C was significantly lower than that of group B(P<0.05),but the multiple pregnancy rate of group C was significantly higher than that of group A and B(P<0.05).Conclusions:In case of failure to obtain high-quality bl

关 键 词：冻融囊胚 移植策略 临床结局 

分 类 号：R711.6[医药卫生—妇产科学]