第7天囊胚的临床使用价值和助孕策略  

Clinical utility value and assisted conception strategies of day 7 blastocyst

作　　者：何晶晶 唐志霞[1] 宣恒华 戴志俊[1] 倪刚 洪名云[1] HE Jingjing;TANG Zhixia;XUAN Henghua;DAI Zhijun;NI Gang;HONG Mingyun(Department of Reproductive Medicine Center,Hefei Maternal and Child Health Hospital,Hefei 230001,Anhui,China)

机构地区：[1]合肥市妇幼保健院生殖医学中心,合肥230001

出　　处：《中国性科学》2025年第4期51-56,共6页Chinese Journal of Human Sexuality

基　　金：合肥市第七周期临床重点(培育)专科建设项目(合卫医秘2023-72号);2023年度安徽省级临床重点专科建设项目(皖卫函2023-320号)。

摘　　要：目的探讨发育天数分别为第5天(D5)、第6天(D6)及第7天(D7)的囊胚在冻融单囊胚移植周期中的临床结局和新生儿出生结局,以及D7囊胚的临床使用价值和助孕策略。方法回顾性分析2015年5月至2024年8月合肥市妇幼保健院收治的行冻融单囊胚移植的1335例患者的临床资料,根据囊胚发育天数分为D5组(n=987)、D6组(n=317)和D7组(n=31),根据囊胚质量将D6组和D7组分为D6优质囊胚组(n=58)、D6非优质囊胚组(n=259)和D7组(n=31)3个亚组。比较D5组、D6组和D7组及3个亚组基线资料、临床结局和新生儿出生结局。结果三组年龄、抗米勒管激素(AMH)、生化妊娠率、临床妊娠率、流产率、活产率比较,差异具有统计学意义(P<0.05)。D7组年龄、流产率高于D5组,AMH、生化妊娠率、临床妊娠率、活产率低于D5组(P<0.05)。D7组年龄、流产率高于D6组,活产率低于D6组(P<0.05)。3个亚组AMH、生化妊娠率、临床妊娠率、流产率、活产率比较,差异具有统计学意义(P<0.05)。D7组年龄、流产率高于D6优质囊胚组,AMH、生化妊娠率、临床妊娠率、活产率低于D6优质囊胚组(P<0.05)。D7组AMH低于D6非优质囊胚组(P<0.05)。结论囊胚发育潜能随着发育天数增加而降低,D7囊胚具有一定的临床妊娠率和活产率,与D6非优质囊胚临床使用价值接近。高龄和低AMH可能更易使胚胎发育缓慢,D7囊胚培养可增加该类患者的胚胎储备数量。Objective To investigate the clinical outcomes and neonatal birth outcomes of blastocysts at the developmental stages of day 5(D5),day 6(D6),and day 7(D7)respectively in frozen-thawed single blastocyst transfer cycles,and the clinical utility value and assisted conception strategies of D7 blastocysts.Methods The clinical data of 1,335 patients who admitted to Hefei Maternal and Child Health Hospital and underwent freeze-thawed single blastocyst transplantation from May 2015 to August 2024 were retrospectively analyzed and divided into D5 group(n=987),D6 group(n=317)and D7 group(n=31)according to the number of blastocyst development days.The D6 group and D7 group were classified into three subgroups including D6 high-quality blastocyst group(n=58),D6 non-high quality blastocyst group(n=259)and D7 group(n=31)according to the quality of blastocyst.The baseline data,clinical outcomes and neonatal birth outcomes were compared between groups D5,D6 and D7 and the three subgroups.Results Comparison of the age,anti-Müllerian hormone(AMH),biochemical pregnancy rate,clinical pregnancy rate,miscarriage rate,and live birth rate among the three groups showed statistically significant differences(P<0.05).The age and miscarriage rate of group D7 were higher than those of group D5,and the AMH,biochemical pregnancy rate,clinical pregnancy rate,and live birth rate were lower than those in group D5(P<0.05).The age and miscarriage rate were higher in group D7 than those in group D6,and the live birth rate was lower than that in group D6(P<0.05).Comparison of the AMH,biochemical pregnancy rate,clinical pregnancy rate,miscarriage rate,and live birth rate among the three subgroups showed statistically significant differences(P<0.05).The age and miscarriage rate of D7 group were higher than those of the D6 high-quality blastocyst group,and the AMH,biochemical pregnancy rate,clinical pregnancy rate,and live birth rate were lower than those of the D6 high-quality blastocyst group(P<0.05).AMH were lower in the D7 group than in the D6 non-h

关 键 词：第7天囊胚 临床妊娠率 流产率 活产率 

分 类 号：R711[医药卫生—妇产科学]