移植冻融优质囊胚的发育天数和数目对临床结局的影响  

The effect of the developmental days and number of transplanted frozen-thawed high-quality blastocysts on clinical outcome

作　　者：包云 余柯达[1] 柴娟[1] 师帅[1] 邹立波[1] BAO Yun;YU Ke-Da;CHAI Juan(Centerof Reproductive Medicine,Jinhua People's Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市人民医院生殖医学中心,浙江金华321000

出　　处：《中国妇幼保健》2022年第22期4219-4222,共4页Maternal and Child Health Care of China

基　　金：浙江省金华市科技计划项目(2019-4-026,2019-4-030,2019-4-036)。

摘　　要：目的 探讨移植冻融优质囊胚的发育天数和数目对临床结局的影响。方法 回顾性分析2018年1月-2019年6月期间在金华市人民医院生殖医学中心接受冻融优质囊胚移植的共392个周期的临床资料,按照冻融时优质囊胚发育天数及移植囊胚数目分为4组,分别为单D5囊胚移植组(SET-5,74个周期)、单D6囊胚移植组(SET-6,83个周期)、双D5囊胚移植组(DET-5,113个周期)及双D6囊胚移植组(DET-6,122个周期),根据囊胚发育天数及囊胚移植数目分别比较临床结局。结果 囊胚发育天数对临床结局的影响,SET-5组的临床妊娠率(58.1%)和种植率(58.1%)显著高于SET-6组的42.2%、42.2%,早期流产率(11.6%)显著低于SET-6组的34.3%,差异均有统计学意义(P<0.05)。DET-5组与DET-6组之间的临床妊娠率、种植率及早期流产率的变化趋势与SET-5组与SET-6组之间的一致。囊胚移植数目对临床结局的影响,在D5/D6中,SET-5/SET-6的临床妊娠率低于DET-5/DET-6,种植率高于DET-5/DET-6,但差异均无统计学意义(P>0.05),可能是病例数不足导致的。DET-5/DET-6的多胎率分别为60.8%和47.6%,显著高于SET-5/SET-6,差异有统计学意义(P<0.05)。结论 复苏周期中,移植D5优质囊胚的临床结局优于D6优质囊胚,且行单囊胚移植可以显著降低多胎妊娠的风险。Objective To explore the effect of the development days and number of transplanted frozen-thawed high-quality blastocysts on clinical outcomes.Methods Retrospective analysis of clinical data was performed on 392 frozen-thawed blastocysts cycles from 2018 to June 2019 in the reproductive medicine center of Jinhua People’s Hospital. All the cycles were divided into 4 groups based the number of days of blastocyst development during freeze-thaw and the number of blastocysts transferred, those single embryo transferred of day5/day6 were labeled as SET-5 group(n=74)/SET-6 group(n=83), those double embryos transferred of day5/day6 were labeled as DET-5 group(n=113)/DET-6 group(n=122). The clinical outcomes were compared according to the number of days of blastocyst development and the number of blastocysts transferred.Results The effect of blastocyst development days on clinical outcome. The clinical pregnancy rate(58.1%) and implantation rate(58.1%) in the SET-5 group were significantly higher than 42.2% and 42.2% in the SET-6 group, and the early miscarriage rate(11.6%) was significantly lower than that in the SET-6 group(34.3%). The differences were statistically significant. The trends of clinical pregnancy rate, implantation rate and early miscarriage rate between DET-5 group and DET-6 group are consistent with those between SET-5 group and SET-6 group. The effect of the number of blastocyst transplantation on clinical outcome. In D5/D6, the clinical pregnancy rate of SET-5/SET-6 is lower than DET-5/DET-6, the implantation rate is higher than DET-5/DET-6, but there was no the statistical significance(P>0.05), which maybe caused by insufficient number of cases. The multiple pregnancy rate of DET-5/DET-6 was 60.8% and 47. 5% significantly higher than SET-5/SET-6, the difference was statistically significant(P<0.05).Conclusion In the resuscitation cycles, the clinical outcome of D5 high-quality blastocyst transplantation is better than D6 high-quality blastocyst, and single blastocyst transplantation can significant

关 键 词：第5日囊胚 第6日囊胚 囊胚移植 临床结局 

分 类 号：R321.33[医药卫生—人体解剖和组织胚胎学]