摘要
目的分析在玻璃化冷冻复苏单囊胚移植周期中,解冻后囊胚扩张程度、内细胞团和滋养细胞质量对临床妊娠的影响。方法收集1005例第一周期复苏单囊胚移植的资料,进行囊胚扩张、内细胞团和滋养细胞评分,采用二分类Logistic回归（Enter法）分析,评估3项评分及年龄对临床妊娠的影响。结果解冻后第5日单囊胚（D5）移植组、第6日单囊胚（D6）移植组的临床妊娠率分别为54.61%、38.49%,组间比较差异有统计学意义（P〈0.01）,D5移植组女方年龄低于D6组（P〈0.01）;D5单囊胚解冻后内细胞团评分低和年龄大是临床妊娠结局的危险因素（OR=1.733,95%CI：1.213-2.475;OR=0.938,95%CI：0.906-0.972,P均〈0.001）,囊胚扩张程度及滋养细胞与妊娠结局无关（P均〉0.05）;D6囊胚解冻移植中妊娠与非妊娠组的囊胚扩张程度、内细胞团、滋养细胞均与妊娠结局无关。结论在进行冷冻复苏单囊胚移植时,D5囊胚优先考虑内细胞团质量。
Objective To evaluate the effect of embryo expansion,inner cell mass and trophectoderm quality on clinical pregnancyduringsingle frozen-thawed blastocyst transfer cycles. Methods A total of1 005 cycles of single blastocyst transfer were collected for grading of embryo expansion,inner cell mass and trophectoderm scoring. Binary logistic regression was utilized to assess the effect of these morphological scores on clinical pregnancy. Results Clinical pregnancy rate in the embryo at 5 d aftersingle embryo transfer（ D5）was 54. 61%,significantly higher compared with 38. 49% in the D6（ P〈0. 01）. The age of patients in the D5 transfer group weresignificantly younger than those in the D6 group（ P〈0. 01）. Low-inner cell mass scoring and high-age were risk factors of clinical pregnancy in D5 single frozen-thawed balstocyst transfer（ OR =1. 733,95% CI： 1. 213 - 2. 475; OR = 0. 938,95% CI： 0. 906 - 0. 972,both P〈 0. 001）,whereas embryo expansion and trophectoderm were not correlated with clinical pregnancy（ both P〉 0. 05）. Embryo expansion,inner cell mass and trophectoderm scoringwere not associated with clinical pregnancy in D6 single blastocyst transferbetween pregnant and non-pregnant groups. Conclusion In D5 frozen-thawed single blastocyst transfer,inner cell mass scoring should be emphasized.
出处
《新医学》
2016年第2期117-121,共5页
Journal of New Medicine
基金
广东省自然科学基金资助项目(s20130100113404)
关键词
单囊胚移植
冷冻复苏胚胎移植
形态学评分
内细胞团
滋养层细胞
Single blastocyst transfer
Frozen-thawed embryo transfer
Morphological scoring
Inner cell mass
Trophectoderm
