摘要
目的:探讨辅助生殖技术治疗后发生单卵双胎(MZT)的相关因素及妊娠结局。方法:回顾分析2007年1月～2017年12月在郑州大学第三附属医院生殖中心行体外受精/单精子卵胞浆内显微注射(IVF/ICSI)-胚胎移植(ET)治疗后获得临床妊娠患者的资料,统计MZT的发生情况,并分析患者年龄、透明带操作、囊胚培养、移植胚胎数与MZT发生的相关性及MZT的妊娠结局。结果:8510个临床妊娠周期中发生MZT 145例,发生率1.70%。囊胚移植组的MZT发生率高于D3胚胎移植组,辅助孵化组的MZT发生率高于未行辅助孵化组,差异均有统计学意义(P<0.01)。年龄、鲜胎移植周期不同授精方式、移植胚胎数与MZT发生无相关性(P>0.05)。与未行减胎术的非MZT双胎妊娠相比,MZT双胎妊娠的流产率高,足月产率、活产率低,差异有统计学意义(P<0.01),早产率、新生儿畸形率差异无统计学意义(P>0.05);与未行减胎术的非MZT双胎妊娠相比,以MZT之一为减胎对象保留双胎妊娠的伴MZT的多胎妊娠流产率、早产率、足月产率、活产率、新生儿畸形率差异无统计学意义(P>0.05); MZT中自然减灭一胎的发生率为18.52%,以MZT之一为减胎对象行减胎术后另一胎发生停育的发生率为25%,差异无统计学意义(P>0.05)。结论:MZT的发生与辅助孵化、囊胚培养相关;未行减胎术的MZT妊娠结局差,以MZT之一为减胎对象的减胎术不增加另一胎停育的发生率,并且可改善MZT的妊娠结局。
Objective:To analyze the factors related to the incidence and outcomes of monozygotic twin(MZT)with assisted reproductive techniques.Methods:The data of clinical pregnancies after in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)and embryo transfer(ET)were retrospectively analysed between Jan.2007 and Dec.2017 in Reproductive Centre of the Third Affiliated Hospital of Zhengzhou University.The relative factors(patients'ages,Day 3 embryos or blastocyst transfer,IVF/ICSI,assisted hatching,the number of embryos transfer)and outcomes of MZT were investigated.Results:145 MZT occurred in 8510 clinical pregnancy cycles with an incidence of 1.70%.The incidence of MZT was significant higher in blastocyst transfer group than that in Day 3 embryo transfer group(P<0.01),and the assisted hatching group gave the same result(P<0.01).Comparing with DZT pregnancy cycles,MZT was associated with a much greater rate of miscarriage and a lower rate of live birth and term birth.There was no significant difference in rate of miscarriage,live birth,term birth and malformation between DZT and MZ-HOMP with one embryo reduction of MZT.The spontaneous abortion incidence of one embryo in MZT was 18.52%,and the incidence of the other one's abortion in MZT after embryo reduction was 25%,there was no significant difference(P>0.05).Conclusions:The incidence of MZT was related to blastocyst transfer and assisted hatching.The pregnancies of MZT were prone to be negative outcomes comparing with DZT,while could get better outcomes after embryo reduction which would not increase the other one's abortion of MZT after embryo reduction.
作者
李静
乔洪武
管一春
王兴玲
Li Jing;Qiao Hongwu;Guan Yichun(Reproductive Centre,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052)
出处
《现代妇产科进展》
CSCD
北大核心
2018年第11期837-840,共4页
Progress in Obstetrics and Gynecology
关键词
辅助生殖技术
单卵双胎
妊娠结局
Assisted reproductive techniques
Monozygotic twins
Pregnancy outcome
