摘要
目的探讨单胚胎移植的妊娠结局及可行性。方法对上海集爱遗传与不育诊疗中心1999-01-2006-06实施的所有体外受精-胚胎移植(IVF-ET)新鲜及冷冻周期中仅有单个胚胎可供移植的共455个周期进行回顾性总结,分析和比较单胚胎移植的妊娠结局与年龄、不孕时间、受精方式、胚胎卵裂球数、胚胎评分、内膜厚度、移植胚胎的天数及新鲜或冷冻胚胎移植的关系。结果单胚胎移植的临床妊娠率18.68%(85/455),无单卵双胎。妊娠与否(1)与年龄无明显相关关系(P>0.05)。(2)与不孕时间相关,妊娠者平均不孕时间为5.53年,未孕者6.73年,P<0.01。(3)与移植时胚胎的卵裂球数目与评分明显相关,妊娠者的平均卵裂球数及评分显著高于未孕组分别为(5.58±2.09)、(4.79±2.19)个;(2.31±0.69)、(2.56±0.73)分,P均<0.01。(4)与移植时胚胎的天数相关,第2(D2)、第3(D3)及第5(D5)天组的临床妊娠率分别为:15.58%,22.75%及26.47%。D3妊娠组所移植胚胎的平均卵裂球数及评分显著高于D2组、P<0.01;另外D5组胚胎达到囊胚的临床妊娠率为40%,而未达囊胚组仅20.83%。(5)IVF与ICSI的单胚胎移植结局无明显差异,临床妊娠率为IVF:20·25%(49/242)及ICSI:16·90%(36/213)。(6)新鲜胚胎(416例)与冷冻胚胎(39例)的单胚胎移植后的临床妊娠率分别为18.27%和23.08%,P>0.05;冷冻组的平均卵裂球数明显多于新鲜胚胎组(P<0.01)。结论IVF-ET周期选择第3天优质胚胎或囊胚行单胚胎移植,可以达到较高的妊娠率并减少多胎妊娠。
Objective To investigate the pregnant outcome after non-elective single embryo transfer. Methods A retrospective analysis was carried out on 455 IVF - ET cycles between January 1 1999 through to June 30 2006. In these 455 cycles, only one embryo was available for transfer （ compulsory single embryo transfer） . Results The average clinical pregnancy rate was 18.68% （ 85 / 455, pregnancy group： P ＋ , non-pregnancy - P-）. The pregnancy rate （PR） was： （ 1 ） not significantly related to women age, P 〉 0. 05 ; （2） negatively related to infertility duration, P ＋ vs. P- ： 5.54 ± 3.42 vs 6.73 ± 3.83 year, P 〈 0.01 ; （3） highly related to the number of blastomere and score of embryo ： Group P ＋ vs. P- ： 5.58 ± 2.09 vs. 4.79 ± 2.19 （blastomere） ;2.31 ± 0. 69 vs. 2.56 ± 0. 73 （ score）, both P 〈 0.01 ; （4） significantly related to embryo age and blastomere cleavage, PR of group D2 ,D3 and D5：15.58% ,22.75% and 26.47%, respectively; the average number of blastomere and score of embryo in D3 were much higher than D2, P 〈0.01 ;further analysis in D5 group, when blastocyst formation on day 5, PR achieved 40% , otherwise only 20.83% ; （5） The fertilization mode was not found to affect the clinical pregnancy rate （IVF： 49/242, 20. 25% vs. ICSI： 36/213, 16. 90%, P 〉0. 05 ） ; （6） clinical pregnancy rate did not differ significantly in fresh 416 cycles and frozen embryo transfer （FET） 39 cycles ： 18.27% vs. 23.08% ,P 〉 0. 05 ; and the number of blastomere in FET embryo was significantly higher than fresh cycles （most of which were D3 embryo）, P 〈 0.01 o Conclusion The single embryo transfer can be applied, and achieve higher pregnancy rate, reducing the risk of multiple pregnancy, while transferring D3 good quality embryo or blastocyst in IVF-ET cycle.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2006年第12期909-911,共3页
Chinese Journal of Practical Gynecology and Obstetrics
