选择性单胚胎移植策略在冻融胚胎移植中的应用效果分析  

Analysis of application effect of elective single embryo transfer in frozen-thawed embryo transfer cycle

作　　者：陈曼[1] 彭三凤 林虹[1] 李志凌[1] CHEN Man;PENG San-feng;LIN Hong;LI Zhi-ling(Reproductive Medicine Department,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041)

机构地区：[1]汕头大学医学院第一附属医院,汕头515041

出　　处：《生殖医学杂志》2022年第7期918-925,共8页Journal of Reproductive Medicine

基　　金：汕头市医疗卫生名医项目(20191231473-6)。

摘　　要：目的探讨选择性单胚胎移植在冻融胚胎移植(FET)周期中的应用效果。方法回顾性分析2020年1月至2021年12月在我院生殖医学科行FET助孕的1233个周期的临床资料。根据患者移植次数不同分为1次组、2次组和多次组;根据患者年龄不同分为<33岁组和≥33岁组。各组内再根据移植胚胎类型、质量及数量进一步分组:D5单囊胚移植组(SBT-D5组),D6单囊胚移植组(SBT-D6组),移植1枚D3优质胚胎组(SET-D3优组),移植2枚D3优质胚胎组(DET-D3优组),移植1枚D3优质胚胎+1枚D3非优质胚胎组(DET-D3组)。比较各组患者的一般资料及临床结局。结果1次组中SBT-D5组、SBT-D6组和SET-D3优组的平均年龄显著低于DET-D3优组和DET-D3组(P<0.05);其余各组间一般资料比较均无显著性差异(P>0.05)。1次组中,SBT-D5组的临床妊娠率显著高于SBT-D6、SET-D3优、DET-D3优组(P<0.05),SBT-D6组的早期流产率显著高于SBT-D5和DET-D3优组(P<0.05);2次组中,SBT-D5、SBT-D6及DET-D3优组的临床妊娠率显著高于SET-D3优组(P<0.05);多次组中,DET-D3优组的临床妊娠率显著高于SET-D3优、DET-D3组(P<0.05)。≥33岁组中SET-D3优组的平均年龄显著高于SBT-D5和SBT-D6组(P<0.05),其余各组间一般资料比较无显著性差异(P>0.05)。<33岁组中,SBT-D5组的临床妊娠率显著高于SBT-D6和SET-D3优组(P<0.05);≥33岁组中,SBT-D5、SBT-D6、DET-D3优组的临床妊娠率显著高于SET-D3优组(P<0.05)。不同移植次数及不同年龄组中,单卵裂胚/囊胚移植组的多胎率均显著低于DET-D3优、DET-D3组(P<0.05)。结论对于40岁以下、首次行FET的患者,优先考虑移植1枚D5囊胚,其次为1枚D6囊胚;对于多次移植失败的患者,可选择双优质卵裂期胚胎移植,但需警惕多胎的发生。Objective:To explore the application effect of elective single embryo transfer in frozen-thawed embryo transfer(FET)cycle.Methods:A total of 1233 FET cycles in the department of reproductive medicine of our hospital from January 2020 to December 2021 were retrospectively analyzed.The patients were divided into 1-time,2-time and multiple-time transfer group according to the number of transplantations,and then they divided into<33 years old group and≥33 years old group according to the patients’age.Subsequently,each group was further divided into five groups according to the type,quality and quantity of embryos transferred:Day 5 single blastocyst transfer group(SBT-Day 5 group),Day 6 single blastocyst transfer group(SBT-Day 6 group),one Day 3 good-quality embryo transfer group(SET-Day 3 good-quality group),two Day 3 good-quality embryos transfer group(DET-Day 3 good-quality group),one Day 3 good-quality embryo+one Day 3 non-good-quality embryo transfer group(DET-Day 3 group).The clinical characters and outcomes were compared among the groups.Results:In the 1-time transfer group,the average age of SBT-Day 5 group,SBT-Day 6 group and SET-Day 3 good-quality group was significantly lower than that of DET-Day 3 good-quality group and DET-Day 3 group(P<0.05),and there was no significant difference in general data among other groups(P>0.05).In the 1-time transfer group,the clinical pregnancy rate of SBT-Day 5 group was significantly higher than that of SBT-Day 6,SET Day 3 good-quality group and DET-Day 3 good-quality groups(P<0.05),and the early abortion rate of SBT-Day 6 group was significantly higher than that of SBT-Day 5 and DET-Day 3 good-quality groups(P<0.05).In the 2-time transfer group,the clinical pregnancy rate of SBT-Day 5,SBT-Day 6 and DET-Day 3 good-quality group was significantly higher than that of SET Day 3 good-quality group(P<0.05).In multiple-time group,the clinical pregnancy rate of DET-Day 3 good-quality group was significantly higher than that of SET-Day 3 good-quality and DET-Day 3 group(P<0.05

关 键 词：选择性单胚胎移植 单囊胚移植 双胚胎移植 冻融胚胎移植 多胎妊娠 

分 类 号：R711.6[医药卫生—妇产科学]