序贯胚胎移植法应用于反复种植失败者的临床结局分析  

Analysis of clinical outcomes of sequential embryo transfer in patients with recurrent implantation failure

作　　者：张永美[1] 刘柳[1] 张松英[1] Zhang Yongmei;Liu Liu;Zhang Songying(Center of Reproductive Medicine,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院生殖医学中心、浙江省生殖障碍诊治研究重点实验室,杭州310000

出　　处：《中华生殖与避孕杂志》2023年第9期913-918,共6页Chinese Journal of Reproduction and Contraception

摘　　要：目的评估序贯胚胎移植法对改善反复胚胎种植失败(recurrent implantation failure,RIF)患者冻融胚胎移植周期临床妊娠结局的作用。方法回顾性队列研究分析2019年1月至2021年9月期间在浙江大学医学院附属邵逸夫医院生殖医学中心行冻融胚胎移植的患者,其中符合RIF诊断标准的患者共842例,按胚胎移植方案分为卵裂期胚胎移植组(n=316)、双囊胚移植组(n=212)、序贯胚胎移植组(n=236)和单囊胚移植组(n=78),比较四组的临床基础信息以及妊娠结局。结果卵裂期胚胎移植组临床妊娠率[39.6%(125/316)]显著低于双囊胚移植组[61.8%(131/212),P<0.001]和序贯胚胎移植组[53.0%(125/236),P<0.001],与单囊胚移植组的临床妊娠率[37.2%(29/78)]相近,双囊胚移植组和序贯胚胎移植组临床妊娠率差异无统计学意义(P>0.05);卵裂期胚胎移植组种植率[23.9%(151/632)]显著低于双囊胚移植组[43.4%(184/424),P<0.001]、序贯胚胎移植组[33.7%(159/472),P<0.001]和单囊胚移植组[35.9%(28/78),P<0.001];双囊胚移植组多胎率[39.7%(52/131)]显著高于卵裂期胚胎移植组[23.2%(29/125),P<0.001]、序贯胚胎移植组[26.4%(33/125),P<0.001]和单囊胚移植组[0%(0/33),P<0.001]。结论对于RIF患者,序贯胚胎移植较卵裂期胚胎移植及单囊胚移植可以提高临床妊娠率,较双囊胚移植可以降低多胎率。Objective To evaluate the effect of sequential embryo transfer on improving clinical pregnancy outcomes during the frozen-thawed embryo transfer cycle in patients with recurrent implantation failure(RIF).Methods A retrospective cohort study was performed in patients who underwent frozen-thawed embryo transfer from January 2019 to September 2021 in the Center of Reproductive Medicine,Sir Run Run Shaw Hospital,Zhejiang University,including 842 patients with RIF.According to the embryo transfer plan,the patients were divided into four groups,including the cleavage embryo transfer group(n=316),two blastocysts transfer group(n=212),sequential embryo transfer group(n=236)and single blastocyst transfer group(n=78).The pregnancy outcome was compared among the four groups.Results The clinical pregnancy rate of cleavage embryo transfer group[39.6%(125/316)]was significantly lower than that of two blastocysts group[61.8%(131/212),P<0.001]and sequential embryo transfer group[53.0%(125/236),P<0.001],and there was no significant difference between two blastocysts group and sequential embryo transfer group(P>0.05).The clinical pregnancy rate was similar in cleavage embryo transfer group and single blastocyst transfer group[37.2%(29/78)].The implantation rate of cleavage embryo transfer group[23.9%(151/632)]was significantly lower than that of two blastocysts transfer group[43.4%(184/424)],sequential embryo transfer group[33.7%(159/472)]and single blastocyst transfer group[35.9%(28/78)],and there were significant differences among the four groups(all P<0.001).The multiple births rate in two blastocysts transfer group[39.7%(52/131)]was significantly higher than that in cleavage embryo transfer group[23.2%(29/125),P<0.001],sequential embryo transfer group[26.4%(33/125),P<0.001]and single blastocyst transfer group[0%(0/33),P<0.001],and there was a significant difference between cleavage embryo transfer group and two blastocysts transfer group(P<0.001).Conclusion For patients with RIF,sequential embryo transfer can improve the clini

关 键 词：反复种植失败 序贯胚胎移植 囊胚 妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]