女性冻卵年龄对冷冻卵子胚胎发育及临床妊娠结局的影响  

Effects of female age at the time of oocyte cryopreservation on embryonic development and clinical pregnancy outcomes

作　　者：胡晴云 季慧[1] 张军强[1] 赵纯[1] 郎鹏 凌秀凤[1] HU Qingyun;JI Hui;ZHANG Junqiang;ZHAO Chun;LANG Peng;LING Xiufeng(Center for Reproductive Medicine,Women′s Hospital of Nanjing Medical University(Nanjing Women and Children′s Healthcare 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,南京210004

出　　处：《中国临床新医学》2025年第3期279-284,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：国家重点研发计划项目(编号:2021YFC2700601-1)。

摘　　要：目的分析女性冻卵年龄对冷冻卵子胚胎发育及临床妊娠结局的影响。方法回顾性分析2013年1月至2024年5月于南京医科大学附属妇产医院进行玻璃化冷冻卵子,并解冻行卵胞质内单精子注射(ICSI)助孕周期女性的临床资料,根据取卵年龄将其分为<35岁组(67例)和≥35岁组(21例)。比较两组的一般临床资料、胚胎发育情况以及临床妊娠结局。结果≥35岁组体质量指数(BMI)水平显著高于<35岁组(P<0.05),两组基础促卵泡激素(FSH)、基础雌二醇(E 2)、基础孕酮(P)、基础黄体生成素(LH)、基础睾酮(T)和超促排方案比较差异无统计学意义(P>0.05)。≥35岁组人绒毛膜促性腺激素(HCG)扳机日的LH水平显著高于<35岁组(P<0.05),两组HCG扳机日的E 2、P水平比较差异无统计学意义(P>0.05)。两组卵子存活率、正常受精率、ICSI后卵子退化率、2原核(2PN)卵裂率、可利用胚胎率、优质胚胎率和囊胚形成率比较差异无统计学意义(P>0.05)。经校正BMI、HCG扳机日内膜厚度、移植胚胎阶段、移植胚胎数、移植优质胚胎数等混杂因素后,多因素logistic回归分析结果显示,相较于<35岁者,≥35岁者鲜胚活产、累积活产的概率显著降低(P<0.05)。结论女性冻卵年龄增加可能会降低胚胎移植后的活产率。Objective To analyze the effects of female age at the time of oocyte cryopreservation on embryonic development and clinical pregnancy outcomes.Methods The clinical data of women who underwent oocyte vitrification freezing and thawing,and received intracytoplasmic sperm injection(ICSI)assisted pregnancy cycle in Women′s Hospital of Nanjing Medical University from January 2013 to May 2024 were retrospectively analyzed.According to the women′s age at the time of oocyte retrieval,they were divided into women<35 years old group(67 cases)and women≥35 years old group(21 cases).The general clinical data,embryonic development and clinical pregnancy outcomes were compared between the two groups.Results The level of body mass index(BMI)in the women≥35 years old group was significantly higher than that in the women<35 years old group(P<0.05).There were no significant differences in basal follicle-stimulating hormone(FSH),basal estradiol(E 2),basal progesterone(P),basal luteinizing hormone(LH),basal testosterone(T)and superovulation protocols between the two groups(P>0.05).The level of LH on human chorionic gonadotropin(HCG)trigger day in the women≥35 years old group was significantly higher than that in the women<35 years old group(P<0.05),while there were no significant differences in the levels of E 2 and P on HCG trigger day between the two groups(P>0.05).There were no statistically significant differences between the two groups in oocyte survival rate,normal fertilization rate,oocyte degeneration rate after ICSI,2 pronuclei(2PN)cleavage rate,usable embryo rate,high-quality embryo rate and blastocyst formation rate(P>0.05).After adjusting for confounders including BMI,endometrial thickness on HCG trigger day,embryo transfer stage,number of transferred embryos,and number of high-quality embryos transferred,the results of multivariate logistic regression analysis showed that compared with those<35 years old,the women≥35 years old had significantly lower probabilities of fresh embryo live birth and cumulative liv

关 键 词：卵子 冻卵年龄 玻璃化冷冻 临床妊娠率 活产率 

分 类 号：R711.6[医药卫生—妇产科学]