新鲜ICSI移植周期D3胚胎卵裂球数目与助孕结局相关性研究  

Correlation between blastomere number of embryos on Day 3 and outcomes in fresh ICSI transfer cycle

作　　者：田文曲 郭娜[1] 任新玲[1] 马冰馨 姚青云 李倪捷 李钰莹 TIAN Wen-qu;GUO Na;REN Xin-ling;MA Bing-xin;YAO Qing-yun;LI Ni-jie;LI Yu-ying(Reproductive Medicine Center,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430000)

机构地区：[1]华中科技大学同济医学院附属同济医院生殖中心,武汉430000

出　　处：《生殖医学杂志》2022年第9期1198-1202,共5页Journal of Reproductive Medicine

基　　金：国家自然科学基金(82004017)。

摘　　要：目的观察新鲜卵胞浆内单精子注射(ICSI)移植周期D3胚胎卵裂球数目不同对妊娠结局和新生儿结局的影响,以期优化单胚胎选择策略。方法回顾性分析2018年1月至2020年12月在本中心行ICSI治疗的2618个新鲜移植周期的临床资料,按照第三天(D3)胚胎卵裂球数目分为6组:≤6细胞组(78例)、7细胞组(199例)、8细胞组(1936例)、9细胞组(178例)、10细胞组(163例)和≥11细胞组(64例),比较组间妊娠结局和新生儿结局。结果妊娠结局的比较:8细胞组的临床妊娠率(52.8%)显著高于≤6细胞组(20.5%)、7细胞组(34.2%)和9细胞组(34.3%),活产率(44.5%)也显著高于≤6细胞组(11.5%)、7细胞组(27.6%)和9细胞组(28.7%),差异均有统计学意义(P<0.001);10细胞组和≥11细胞组的临床妊娠率和活产率略低于8细胞组,差异尚无统计学意义(P>0.05)。新生儿结局的比较:7细胞组的低出生体重儿占比显著高于8细胞组(10.9%vs.2.7%,P<0.001),组间其他新生儿结局指标差异均无统计学意义(P>0.05);≤6细胞组获得9例健康活产儿。结论新鲜ICSI移植周期中,优先考虑移植D3的8细胞胚胎,其次为10个及以上细胞的胚胎;9细胞胚胎和7细胞胚胎具有相似的临床结局,但7细胞胚胎低出生体重儿风险增加;当没有优质胚胎可供移植时,≤6细胞胚胎依然有健康活产的机会。Objective:To explore the effects of different blastomere number of embryos on Day 3 on pregnancy and neonatal outcomes in fresh ICSI transfer cycle,in order to optimize the selection strategy of embryo.Methods:The clinical data of 2618 patients received ICSI treatment in our center from January 2018 to December 2020 were retrospectively analyzed.The patients were divided into 6 groups according to the blastomere number of embryos on Day 3:≤6 cell group(n=78),7-cell group(n=199),8-cell group(n=1936),9-cell group(n=178),10-cell group(n=163)and≥11 cell group(n=64).Pregnancy and neonatal outcomes were compared among the groups.Results:The clinical pregnancy rate in 8-cell group(52.8%)were significantly higher than that in≤6 cell group(20.5%),7-cells group(34.2%)and 9-cell group(34.3%),and live birth rate in 8-cell group(44.5%)were significantly higher than that in≤6 cell group(11.5%),7-cell group(27.6%)and 9-cell group(28.7%)(P<0.001).The clinical pregnancy rate and the live birth rate in 10-cell group and≥11 cell group were slight lower than those in 8-cell group,but the difference was not significant(P>0.05).The proportion of low birth weight in 7-cell group was significantly higher than that in 8-cell group(10.9%vs.2.7%,P<0.001).There was no significant difference in other neonatal outcome indicators among the groups(P>0.05).The≤6 cell group received 9 healthy live babies.Conclusions:In the fresh ICSI transfer cycle,priority is given to the transfer of 8-cell embryos of Day 3,followed by embryos with 10 or more cells.9-cell embryos and 7-cell embryos have similar clinical outcomes,but the risk of low birth weight infants with 7-cell embryos is increased.When there is no high-quality embryo for transfer,embryos with≤6 cell still have the chance of healthy live birth.

关 键 词：卵裂球数 辅助生殖技术 妊娠结局 延时成像 

分 类 号：R711.6[医药卫生—妇产科学]