多囊卵巢综合征患者多原核合子的发生对冻胚移植结局的影响  

Effect of multiple pronuclei on the outcome of frozen-thawed embryo transfer in patients with polycystic ovarian syndrome

作　　者：王莉[1] 杨烨 谢奇君 彭丽君 杨玉琴 凌秀凤[1] WANG Li;YANG Ye;XIE Qi-jun;PENG Li-jun;YANG Yu-qin;LING Xiu-feng(Reproductive Center,Women′s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital),Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)生殖医学中心,210004

出　　处：《中国生育健康杂志》2024年第5期430-437,共8页Chinese Journal of Reproductive Health

基　　金：国家自然科学基金(81871210)。

摘　　要：目的比较多囊卵巢综合征(PCOS)人群多原核(PN)合子的发生率对体外受精(IVF)周期胚胎发育情况及冻融胚胎移植(FET)结局的影响。方法回顾性分析2016年1月至2021年12月于南京医科大学附属妇产医院进行IVF治疗的2665例患者资料。根据不孕原因分为PCOS组(N=1295)和对照组(N=1370),比较两组多PN发生率。在PCOS组中进一步仅纳入全胚冷冻并进行FET的患者,排除失访或未到分娩日期的患者,最终纳入999例PCOS患者,根据受精情况分为三个亚组:2PN组547例,低比例多PN组(多PN率≤20%)414例,高比例多PN组(多PN率>20%)38例,比较三个亚组的临床结局。结果PCOS组多PN率高于对照组(P<0.05)。低比例多PN组基础AMH、获卵数、IVF卵子数高于2PN组(P<0.05),可移植胚胎数、囊胚形成率、优质囊胚数低于2PN组(P<0.05),生化妊娠率和活产率低于2PN组(P<0.05)。高比例多PN组获卵数、IVF卵子数低于低比例多PN组(P<0.05),可移植胚胎数、囊胚形成率、优质囊胚数低于2PN组和低比例多PN组(P<0.05),生化妊娠率和活产率低于2PN组和低比例多PN组(P<0.05)。各组间胚胎种植率和临床妊娠率无统计学差异(P>0.05)。结论行FET的PCOS患者多PN发生会降低胚胎质量,影响生化妊娠率和活产率。Objective To investigate the impact of multiple pronuclei(PN)on the outcome of frozen-thawed embryo transfer(FET)in infertile women with polycystic ovary syndrome(PCOS).Methods A total of 2665 patients who underwent IVF treatment in Women′s Hospital of Nanjing Medical University from January 2016 to December 2021 were retrospectively analyzed.First,they were divided into PCOS group(N=1295)and control group(N=1370)according to the cause of infertility,and the incidence of multiple PN was compared between the two groups.Subsequently,we only included patients whose whole embryos were frozen and underwent FET in the PCOS group,and excluded those who were lost to follow-up or who had not yet arrived for delivery.Finally,999 PCOS patients were included and divided into three subgroups according to fertilization status:547 patients in the 2PN group,414 cases in the low-proportion multiple PN group(multiple PN rate≤20%),and 38 cases in the high-proportion multiple PN group(multiple PN rate>20%).The clinical outcomes of these three subgroups were compared.Results The PCOS group had a significantly higher rate of multiple PN than the control group(P<0.05).Compared with patients in the 2PN group,those in the the low proportion of multi-PN group had higher baseline AMH,number of oocytes retrieved and number of IVF oocytes(P<0.05),lower number of transferable embryos,blastocyst formation rate and high-quality blastocysts,biochemical pregnancy rate and live birth rate were lower(P<0.05).The number of retrieved oocytes and IVF oocytes in high proportion of multi-PN group were lower than those in low proportion of multi-PN group(P<0.05),the number of transferable embryos,blastocyst formation rate,and high-quality blastocysts in low proportion of multi-PN group were lower than those in 2PN group and low proportion of multi-PN group(P<0.05),and the biochemical pregnancy rate and live birth rate were lower than those in 2PN group and low proportion of multi-PN group(P<0.05).There was no significant difference in embryo implanta

关 键 词：多囊卵巢综合征 多原核 冻胚移植 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]