摘要
目的探讨新鲜周期小于40岁患者选择性单囊胚和卵裂期胚胎移植的妊娠结局。方法回顾性分析2016年1月至2017年10月在广东省中医院生殖医学科行体外受精-胚胎移植(IVF-ET)的405例患者的治疗情况,根据移植时间和方式不同分成两组:选择性单囊胚移植组(eSBT组,101例)和卵裂期胚胎移植组(D3ET组,304例)。结果两组患者女方年龄、男方年龄、基础FSH、基础E2、不孕年限、女性BMI、不孕因素比较,差异均无统计学意义(P>0.05);eSBT组和D3ET组相比,除Gn使用天数外,Gn使用剂量、获卵数、可利用胚胎数、优质胚胎数、受精卵数及移植胚胎数差异均有统计学意义(P<0.01);两组患者的临床妊娠率和流产率均无统计学差异(P>0.05);eSBT组的着床率显著高于D3ET组(55.4%vs.41.3%,P<0.01);eSBT组未出现多胎妊娠,而D3ET组多胎妊娠率为35.6%,两组差异极显著(P<0.01);eSBT组和D3ET组患者活产率(45.5%vs.49.7%)、男女性别比(110vs.110)、胎儿畸形发生率(2.2%vs.1.6%)差异均无统计学意义(P>0.05);eSET组早产率略低于D3ET组(13.0%vs.21.2%),但差异没有统计学意义(P>0.05);eSET组双胎出生率(0vs.25.2%)及出生低体重儿发生率(13.0%vs.29.1%)均显著低于D3ET组(P<0.05)。结论在小于40岁预后好的患者中,选择性单囊胚移植可保证临床妊娠率和活产率的同时有效降低多胎妊娠。
Objective:To compare the pregnant outcome of elective single blastocyst transfer(eSBT)and cleavage-stage embryo transfer(Day 3 ET)in women undergoing fresh embryo transfer under 40 years old.Methods:The data of 405 cycles of fresh embryo transfer of IVF/ICSI treatment including eSBT(n=101)and Day 3 ET(n=304)in the Department of Reproductive Medicine,Guangdong Provincial Hospital of Chinese Medicine from January 2016 to October 2017.Results:There were no significant differences in female age,male age,baseline level of FSH and E 2,duration of infertility,female BMI and infertility factors between the two groups(P >0.05).There were significant differences in total gonadotrophin dose used,numbers of oocytes retrieved,embryos available,high quality embryos,fertilized oocytes and embryos transferred(P<0.05)except the days of gonadotropin used(P >0.05).The clinical pregnancy rate and abortion rate were not significantly different between the eSBT group and the Day 3 ET group(P >0.05).The implantation rate of the eSBT group was significantly higher than that of Day 3 ET group(55.4%vs.41.3%,P<0.01).No multiple pregnancy occurred in the eSBT group,whereas the multiple pregnancy rate of the Day 3 ET group was 35.6%;the difference was significant between the two groups(P<0.01).There were no significant differences in live birth rate(45.5%vs.49.7%),male-female ratio(110 vs.110),fetal malformation rate(2.2%vs.1.6%)between eSBT group and Day 3 ET group(P >0.05).However,the rate of preterm birth was slightly lower in the eSBT group(13.0%),as compared to the Day 3 ET group(21.2%),but the difference was not significant.The difference of the twin birth rate between the two groups was significantly different(0 vs.25.2%,P<0.01).The incidence of low birth weight infants was significantly lower in the eSBT group than that in the Day 3 ET group(13.0%vs.29.1%,P<0.05).Conclusions:Elective single blastocyst transfer can ensure the pregnancy rate and live birth rate while effectively reducing multiple pregnancy in the women with a good prog
作者
谢妍
杨冬宇
陈旭龙
李思楠
周文
周欢群
袁启龙
陆杉
XIE Yan;YANG Dong-yu;CHEN Xu-long;LI Si-nan;ZHOU Wen;ZHOU Huan-qun;YUAN Qi-long;LU Shan(Department of Reproductive Medicine,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou510000)
出处
《生殖医学杂志》
CAS
2019年第2期140-145,共6页
Journal of Reproductive Medicine
基金
广东省医学科学技术研究基金项目(A2017152)
关键词
新鲜周期
单囊胚
胚胎移植
多胎率
Fresh cycle
Single blastocyst
Embryo transfer
Multiple pregnancy rate
