单个体外受精周期仅获得≤2个低评分卵裂期胚胎的处置方式探讨  

Discussion of the disposal mode of only 1 or 2 embryos with extremely poor morphological score in cleavage stage of women with a single in-vitro fertilization cycle

作　　者：谭颖 马从顺 崔媛媛 詹雪君 朱婉珊 刘宇 陈潇 TAN Ying;MA Congshun;CUI Yuanyuan;ZHAN Xuejun;ZHU Wanshan;LIU Yu;CHEN Xiao(Guangdong Provincial Re productive Science Institute(Guangdong Provincial Fertility Hospital),NHC Key Laboratory of Male Re production and Genetics,Guangzhou,Guangdong Province,510600)

机构地区：[1]广东省生殖科学研究所,广东省生殖医院,国家卫生健康委员会男性生殖与遗传重点实验室,广州510600

出　　处：《中国计划生育学杂志》2024年第8期1777-1780,1786,共5页Chinese Journal of Family Planning

基　　金：广东省医学科学研究基金(B2022088)。

摘　　要：目的:比较体外受精周期仅获得≤2个4细胞或5细胞Ⅲ级低评分卵裂期胚胎新鲜移植或囊胚培养的临床结局。方法:收集2013年1月-2022年12月在广东省生殖医院行体外受精-胚胎移植(IVF-ET)助孕且单个取卵周期配成≤2个4/5细胞Ⅲ级胚胎且无其它胚胎的患者共185个周期,根据取卵后第3天(D3)患者意愿分为移植组(n=72)、养囊组(n=113),观察两组有效胚胎利用率、当次取卵周期的累积妊娠率及累积活产率。结果:养囊组可用囊胚形成率为3.9%,208个低级别胚胎进行囊胚培养共形成8枚可用囊胚,囊胚移植后临床妊娠率及种植率75.0%,移植周期活产率为50.0%;移植组妊娠率为19.4%,有效胚胎利用率(12.5%)高于养囊组(2.9%),取卵周期累积妊娠率(19.4%)及累积活产率(11.1%)均高于养囊组(5.3%、2.7%)(均P<0.05)。结论:4/5细胞低评分胚胎成囊率低下,但是一旦形成囊胚妊娠率较高;若患者无其它胚胎可选择且有强烈移植意愿,可在充分知情同意下进行新鲜移植,可获得一定妊娠率,但是此类胚胎新鲜移植仍需慎重考虑。Objective:To compare the clinical outcomes of the fresh embryo transfer or blastocyst culture by only 1 or 2embryos with 4 or 5 cells andⅢgrade low morphological score in cleavage stage of women with a single in-vitro fertilization(IVF)cycle.Methods:185 cycles of single in vitro fertilization-embryo transfer(IVF-ET)by 1 or 2Ⅲgrade embryos with 4 or 5 cells in cleavage stage of the women from Jan,2013 to Dec,2022 were collected in this study.According to the intention of the embryos transfer,these women were divided into group A(72 women with fresh embryos transfer)and group B(113 women with blastocyst culture).The incidences of the effective embryo utilization,the accumulating clinical pregnancy rate in the cycles of eggs obtained and the accumulating live birth of the women in the two groups were observed.Results:In group B,the available blastocyst formation rate of the women was 3.9%,8 available blastocysts were formed by the blastocyst culture from 208 embryos with low morphological score,and the clinical pregnancy rate and the live birth rate of the women after blastocyst transfer were 75%and 50%.In group A,the pregnancy rate of the women was 19.4%.The rate of effective embryo utilization(12.5%)of the women in group A was significantly higher than that(2.9%)of the women in group B.The cumulative pregnancy rate(19.4%)and the cumulative live birth rate(11.1%)of the women in group A were significantly higher than those(5.3%and 2.7%)of the women in group B(all P<0.05).Conclusion:The blastocyst formation rate of the embryo with 4/5 cells and low poor morphological score is low,while the pregnancy rate of the formed blastocyst is high.If the woman has no other embryo transfer option and has a strong desire to the embryo transfer,the fresh embryo transfer can be performed for the woman under her full informed consent,and which can be obtained a certain pregnancy rate,but such fresh embryo transfer for this woman still needs to be thought about carefully.

关 键 词：体外受精-胚胎移植 极低评分胚胎 新鲜移植 囊胚培养 有效胚胎利用率 活产率 

分 类 号：R714.8[医药卫生—妇产科学]