摘要
目的·探讨在体外受精-胚胎移植冻融周期中,胚胎的质量是否会影响临床结局导致生化妊娠或早期胚胎停止发育。方法·回顾性分析2015年1月至2016年6月在上海交通大学医学院附属瑞金医院生殖中心行冻融胚胎移植治疗后生化妊娠的115个周期、早期胚胎停止发育的64个周期、继续妊娠的871个周期的临床资料,比较移植后第3天(D3)胚胎质量及评分和囊胚发育速度、囊胚级别在3组之间的差异。结果·在男女双方年龄、不孕年限、排卵日子宫内膜厚度、移植日雌二醇和孕酮水平等方面3组之间比较,差异无统计学意义(P>0.05)。多数D3冻融胚的评分为6~8分,且各分值所占比例在3组之间比较,差异无统计学意义(P>0.05)。3组中移植的D5囊胚所占的比例均高于D6囊胚所占的比例,但3组之间比较,差异无统计学意义(P>0.05)。评级为A、B的囊胚内细胞团比例和评级为C的囊胚内细胞团比例在3组中分别比较,差异均无统计学意义;但在胚胎停止发育组中,评级为C的囊胚滋养层所占的比例为52.2%,明显高于生化妊娠组(35%)和继续妊娠组(29.3%)中相应的比例,且差异均有统计学意义(P<0.05)。结论·胚胎质量与生化妊娠没有必然关系,而囊胚滋养层的评级可能是胚胎早期停止发育的主要原因之一。
Objective · To investigate whether the quality of embryos will result in biochemical pregnancy or arrest of embryo development in the freezing and thawing cycles of in-vitro fertiliazation-embryo transfer （IVF-ET）. Methods · The clinical data of patients who accepted IVF-ET in Center of Reproductive Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2015 to June 2016 were retrospectively studied. The data includes 115 cycles of biochemical pregnancy, 64 cycles of arrest of early embryonic development and 871 cycles of ongoing pregnancy after frozen thawed embryo transfer. We compared the embryo score on the third day after embryo transfer （D3）, the blastocyst development rate and the blastocyst grade in the three groups. Results · There were no significant differences in the period of infertility, the age of the patients and their spouses, the endometrial thickness, the estrogen and progestogen levels of the day of transplantation among the three groups （P 〉 0.05）. The scores of most frozen thawed embryos on D3 were from 6 to 8, and the scores were not statistically significant among the three groups （P 〉 0.05）. The proportion of transplanted blastocyst on D5 was higher than that on D6 in the three groups, but there was no significant difference among the three groups （P 〉 0.05）. There was no significant difference in the proportion of inner cell mass of blastocysts which were scored as Grade A＆B or Grade C among the three groups. Nevertheless, in the arrest of early embryonic development group, the proportion （52.2%） of the trophoblast of blastocysts which were cored as Grade C was significantly higher than the proportion （35%） in biochemical pregnancy group and the proportion （29.3%） in ongoing pregnancy group （P〈0.05）. Conclusion · The quality of embryos is not necessarily related to biochemical pregnancy, but the score of trophoblastic may be related to the arrest of early embryo growth.
作者
夏兰
吴娴
徐慧慧
赵甡
徐步芳
张爱军
XIA Lan WU Xian XU Hui-hui ZHAO Shen XU Bu-fang ZHANG Ai-jun(Center of Reproductive Medicine, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200025, Chin)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2017年第3期344-347,共4页
Journal of Shanghai Jiao tong University:Medical Science
基金
国家自然科学基金(81300548
81370763)~~
关键词
胚胎质量及评分
囊胚
生化妊娠
胚胎早期停止发育
the quality and the score of embryos
blastocyst
biochemical pregnancy
arrest embryo development
