卵裂期优质胚胎与非优质胚胎来源的囊胚冻融移植后着床率比较  

Comparison of implantation rate of blastocyst between high-quality embryos and non-high-quality embryos during cleavage stage after freeze-thaw transfer

作　　者：贾珠 张宁[2] JIA Zhu;ZHANG Ning(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong Province,China;Reproductive and Genetic Center,the First Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong Province,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]山东中医药大学第一附属医院生殖与遗传中心,山东济南250014

出　　处：《新乡医学院学报》2023年第11期1039-1046,共8页Journal of Xinxiang Medical University

基　　金：山东省自然科学基金资助项目(编号:ZR2021MH003)。

摘　　要：目的比较卵裂期优质胚胎与非优质胚胎来源的囊胚进行冻融囊胚移植(FET)的囊胚着床率,探讨卵裂期非优质胚胎来源的囊胚移植价值。方法选择2018年1月至2022年1月于山东中医药大学第一附属医院生殖与遗传中心行FET的613枚受精后5 d(D_(5))囊胚为研究对象,根据其在受精后3 d(D_(3))是否为优质胚胎将其分为优质组(n=158)和非优质组(n=455)。分别比较2组不同内膜准备方案、囊胚腔不同扩张程度、不同级别内细胞团(ICM)、不同级别滋养外胚层(TE)的囊胚着床率以及不同等级囊胚的着床率。结果优质组囊胚着床率为37.97%(60/158);其中自然周期方案、替代周期方案、降调节+替代周期方案、促排卵周期方案的囊胚着床率分别为38.30%(18/47)、41.82%(23/55)、36.67%(11/30)、30.77%(8/26);优质组4种内膜准备方案的囊胚着床率比较差异无统计学意义(χ^(2)=0.942,P>0.05)。非优质组囊胚着床率为33.41%(152/455);其中自然周期方案、替代周期方案、降调节+替代周期方案、促排卵周期方案的囊胚着床率分别为31.01%(40/129)、32.43%(36/111)、23.30%(7/30)、37.30%(69/185);非优质组4种内膜准备方案的囊胚着床率比较差异无统计学意义(χ^(2)=3.008,P>0.05)。优质组与非优质组的囊胚着床率以及自然周期方案、替代周期方案、降调节+替代周期方案、促排卵周期方案的囊胚着床率比较差异均无统计学意义(χ^(2)=1.082、0.829、1.414、1.270、0.419,P>0.05)。优质组中囊胚腔扩张程度2级、3级、4级、5级的囊胚着床率分别为6.25%(1/16)、35.40%(25/71)、46.38%(32/69)、0.00%(0/2);囊胚腔扩张程度3、4级的囊胚着床率高于2级(χ^(2)=5.227、8.805,P<0.05);囊胚腔扩张程度3级与4级囊胚着床率比较差异无统计学意义(χ^(2)=1.807,P>0.05)。非优质组中囊胚腔扩张程度2级、3级、4级、5级的囊胚着床率分别为40.43%(19/47)、31.07%(64/206)、34.03%(65/191)、36.36%(4/11);非优�Objective To compare the blastocyst implantation rate of high-quality embryos and non-high-quality embryos during cleavage stage underwent frozen-thawed blastocyst transfer(FET),and to explore the transfer value of blastocysts from non-high-quality embryos.Methods A total of 613 blastocysts at 5 days after fertilization(D_(5))underwent FET at the Reproductive and Genetic Center of the First Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January,2018 to January,2022 were selected as the research objects.According to whether they were high-quality embryos at 3 days after fertilization(D_(3)),they were divided into high-quality group(n=158)and non-high-quality group(n=455).The blastocyst implantation rates of different endometrial preparation protocols,different expansion degrees of blastocyst cavity,different grades of inner cell mass(ICM),different grades of trophoblastic ectoderm(TE)and different grades of blastocyst were observed respectively.Results The blastocyst implantation rate of the high-quality group was 37.97%(60/158);the blastocyst implantation rates of natural cycle plan,alternative cycle plan,down regulation+alternative cycle plan and ovulation induction cycle plan were 38.30%(18/47),41.82%(23/55),36.67%(11/30)anD_(3)0.77%(8/26),respectively.There was no significant difference in the blastocyst implantation rate among the four endometrial preparation schemes in the high-quality group(χ^(2)=0.942,P>0.05).The blastocyst implantation rate in the non-high-quality group was 33.41%(152/455);the blastocyst implantation rates of natural cycle,alternative cycle plan,down-regulation+alternative cycle plan and ovulation induction cycle plan were 31.01%(40/129),32.43%(36/111),23.30%(7/30)anD_(3)7.30%(69/185),respectively.There was no significant difference in the blastocyst implantation rate among the four endometrial preparation schemes in the non-high-quality group(χ^(2)=3.008,P>0.05).There was no significant difference in the total blastocysts implantation rate between the h

关 键 词：卵裂期 优质胚胎 非优质胚胎 冻融囊胚移植 囊胚等级 囊胚着床率 

分 类 号：R715.2[医药卫生—妇产科学]