IVF/ICSI-ET周期移植非优质胚胎的结局分析  

Outcome analysis of non-good quality embryos transfer in IVF/ICSI-ET cycle

作　　者：陈一文 谢中亚 卜志勤[1] 毕钡钡 胡琳莉[1] CHEN Yi-wen;XIE Zhong-ya;BU Zhi-qin;BI Bei-bei;HU Lin-li(Center for Reproductive Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院生殖医学中心,郑州450052

出　　处：《生殖医学杂志》2023年第9期1297-1304,共8页Journal of Reproductive Medicine

基　　金：国家自然科学基金(82171658)。

摘　　要：目的分析取卵后第3天(D3)未形成优质卵裂期胚胎的患者移植不同发育时期胚胎的结局。方法回顾性分析2015年1月至2021年6月在郑州大学第一附属医院生殖医学中心进行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕的患者资料,筛选在第3天未形成优质胚胎的新鲜周期,根据胚胎移植时期分为:卵裂期移植组(n=462)和囊胚期移植组(n=198),比较两组患者的基本资料、妊娠结局以及两组成功分娩的新生儿结局和产科并发症情况,并分析胚胎移植时期对上述结局变量的影响。结果两组患者的基本资料中,囊胚期移植组的平均取卵周期数、移植胚胎数均显著小于卵裂期移植组(P<0.05)。妊娠结局比较中,与卵裂期移植组相比,囊胚期移植组的HCG阳性率(56.1%vs.26.2%)、临床妊娠率(50.0%vs.22.3%)、活产率(40.9%vs.16.2%)均显著升高(P<0.001),流产率及多胎妊娠率无显著性差异(P>0.05)。按取卵周期数分层分析后,取卵周期数≤2的患者囊胚期移植组的HCG阳性率、临床妊娠率、活产率均显著高于卵裂期移植组(P<0.001);而在取卵周期数≥3的患者中,两组的HCG阳性率、临床妊娠率和活产率差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示胚胎移植时期是HCG阳性率、临床妊娠率和活产率的独立影响因素(P<0.001);而对于取卵周期数≥3的患者,胚胎移植时期对HCG阳性率、临床妊娠率和活产率并无显著影响(P>0.05)。两组患者成功分娩的新生儿男性占比、胎龄、出生体重、身长以及低出生体重儿、巨大儿和早产儿的发生率均无统计学差异(P>0.05);母亲妊娠期高血压、糖尿病和胎膜早破发生率、剖宫产率在两组间也均无统计学差异(P>0.05)。多因素Logistic回归分析表明胚胎移植时期对新生儿结局及产科并发症发生率无显著影响(P>0.05)。结论在IVF/ICSI-ET周期受精第3天未形成优质胚胎的患者中,移植�Objective:To analyze the outcome of embryo transfer at different developmental stages in patients who failed to form good-quality cleavage embryos on Day 3 in IVF/ICSI-ET cycles.Methods:A retrospective analysis was conducted on the data of patients who underwent IVF/ICSI-ET assisted pregnancy in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2015 to June 2021.A total of 1724 fresh cycles failed to form good-quality embryos on Day 3 were selected.According to the stage of embryos transferred,the cycles were divided into two groups:cleavage stage transfer group(n=462)and blastocyst transfer group(n=198).The basic data,pregnancy outcome,neonatal outcome and obstetric complications were compared between the two groups,and the influence of stage of embryo transferred on the above outcome variables was analyzed.Results:In the basic data of the two groups,the average number of oocyte retrieval cycles and the number of embryos transferred in blastocyst transfer group were significantly less than those in cleavage transfer group(P<0.05).In the comparison of pregnancy outcomes,the positive rate of HCG(56.1%vs.26.2%),clinical pregnancy rate(50.0%vs.22.3%)and live birth rate(40.9%vs.16.2%)in blastocyst transfer group were significantly higher than those in cleavage transfer group(P<0.001),while there was no significant difference in abortion rate and multiple pregnancy rate between the two groups(P>0.05).After stratified analysis according to the number of oocyte retrieval cycles,the HCG positive rate,clinical pregnancy rate and live birth rate in blastocyst transfer group were significantly higher than those in cleavage transfer group in the patients with number of oocyte retrieval cycle≤2(P<0.001).However,there were no significant differences in HCG positive rate,clinical pregnancy rate and live birth rate between the two groups in the patients with number of oocyte retrieval cycles≥3(P>0.05).Multivariate logistic regression analysis showed that the stage of embry

关 键 词：体外受精/卵胞浆内单精子注射-胚胎移植 非优质胚胎 囊胚培养 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]