囊胚腔再扩张状态对冻融周期单囊胚移植临床结局的影响  

Effect of blastocoele re-expansion on clinical outcome in frozen-thawed single blastocyst transfer

作　　者：秦祖兴 唐妮 杨柳红 韦莉莉 张明 唐永梅 李楠 范莉 QIN Zuxing;TANG Ni;YANG Liuhong;WEI Lili;ZHANG Ming;TANG Yongmei;LI Nan;FAN Li(Reproductive Center,Liuzhou Maternity and Child Healthcare Hospital,Liuzhou Institute of Reproduction and Genetics,Guangxi Clinical Research Center for Obstetrics and Gynecology,Liuzhou,Guangxi 545001,China)

机构地区：[1]柳州市妇幼保健院生殖医学中心/柳州市生殖与遗传研究所/广西妇产疾病临床医学研究中心,广西柳州545001

出　　处：《中国优生与遗传杂志》2023年第11期2272-2276,共5页Chinese Journal of Birth Health & Heredity

基　　金：广西科技计划项目(桂科AD22035223);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20180029、Z-B20231520)。

摘　　要：目的探讨囊胚腔再扩张状态对冻融周期单囊胚移植临床结局的影响。方法回顾性分析2020年1月至2021年12月在柳州市妇幼保健院生殖医学中心完成的1271个冻融周期单囊胚移植患者的临床资料和临床结局。入组标准:年龄≤38岁、内膜转化日子宫内膜厚度≥7mm、移植单个4期优质囊胚(BB级以上评级囊胚),并排除PGT患者。结果对于D5单囊胚移植组,随着囊胚腔再扩张程度的提高,临床妊娠率和胚胎种植率有提高的趋势。并且,中度扩张组临床妊娠率和胚胎种植率显著低于完全扩张组和部分孵出组(54.3%vs 72.4%vs 73.0%,均P<0.05)。中度扩张组足月分娩率显著低于完全扩张组(77.5%vs 79.6%,P<0.05)。其他指标无显著性差异(均P>0.05)。对于D6单囊胚移植组,随着囊胚腔再扩张程度的提高,临床妊娠率和胚胎种植率也有提高的趋势。并且,低扩张组临床妊娠率和胚胎种植率显著低于部分孵出组(20.0%vs 69.2%,P<0.05)。但是,部分孵出组早产率显著高于完全扩张组(22.2%vs 5.8%,P<0.05)。其他指标无显著性差异(均P>0.05)。结论冻融周期D 5或D 6单囊胚移植中,囊胚腔再扩张状态均与临床妊娠率和胚胎种植率存在一定正相关性,可以作为临床妊娠率和胚胎种植率的预测指标。Objecti ve To investigate the effect of blastocoele re-expansion on the clinical outcome in froz en-thawed single blastocyst transfer cycles.Methods A total of 1271 frozen-thawed single blastocyst transfer cycles from January 2020 to December 2021 in Liuzhou Maternity and Child Healthcare Hospital Reproductive Center were retrospectively studied.Patients’general data and clinical outcomes were retrospectively analyzed.The inclusion criteria was age of female patient≤38 years,endometrial thickness≥7 mm on the day of endometrial transformation,and transfer cycleof a single 4-stage high-quality blastocyst(grade BB or above).PGT transfer cycles were excluded.Results For D5 frozen-thawed single blastocyst transfer cycles,the clinical pregnancy rate and embryo implantat ion rate t ended to increase with the degreeof blastocoele re-expansion.The clinical pregnancy rat e and embryo implantation ratein moderat e re-expansion group were significant ly lower than that in full re-expansion group and part ial hatching group(54.3%vs 72.4%vs 73.0%,P<0.05).The full-term delivery rate in moderate re-exp ansion group was significantly lower than that infull re-expansion group(77.5%vs 79.6%,P<0.05).There were no significant differences in other indexes(P>0.05).For D6 froz en-thawed single blastocysttransfer cycles,the clinical pregnancy rate and embryo implantation rate also tended to increase with the degree of blastocoele re-expansion.The clinical pregnancy rate and embryo implant ation rate in low re-expansion group were significant ly lower than that in partial hatching group(20.0%vs 69.2%,P<0.05).However,the preterm birth rate in hat ching groupwas significant ly higher than that in full expansion group(22.2%vs 5.8%,P<0.05).There were no significant differences in other indexes(P>0.05).Conclusion There were posit ive correlation between the blastocoele re-expansion and the clinical pregnancy rate or embryo implantat ion ratein both D5 and D6 frozen-thawed single blastocyst transfer cycles.Blastocoele re-expansion is a pr

关 键 词：冻融周期 单囊胚移植 囊胚腔再扩张 临床妊娠率 胚胎种植率 

分 类 号：R722.1[医药卫生—儿科]