摘要
目的通过消失双胎(vanishingtwin)控制母体因素探讨辅助生殖技术后枯萎卵的发生风险和相关胚胎因素。方法回顾性分析2012年1月至2018年1月在南方医科大学南方医院生殖医学中心行体外受精(IVF)/卵胞浆内单精子显微注射(ICSI)双胎移植后临床双胎妊娠共610例,根据移植后超声检查和妊娠结局分为枯萎卵合并单胎活产(枯萎卵组)136例和同期双胎活产组474例,比较两组年龄、BMI、基础窦卵泡数(AFC)、基础卵泡刺激素(b FSH)/基础黄体生成激素(b LH)比值等母体因素以及胚胎因素如受精方式、移植胚胎类型及移植胚胎的D3时期优质胚胎占比等。结果(1)两组血清β-h CG和囊胚期胚胎移植率比较,差异有统计学意义(P<0.05);双方年龄、BMI、AFC、bFSH/bLH、不孕因素等母体因素比较,差异均无统计学意义;受精方式、移植周期及移植胚胎的D3时期优质胚胎占比等比较,差异无统计学意义。(2)多因素Logistic回归分析显示,囊胚期胚胎移植是枯萎卵发生的危险因素(OR=19.386,P<0.05),血清β-hCG是枯萎卵的保护因素(OR=0.290,P<0.05)。结论枯萎卵合并单胎活产作为消失双胎的一种类型,可一定程度上控制枯萎卵相关母体因素,囊胚期胚胎移植增加枯萎卵的发生风险,而低血清β-hCG水平是枯萎卵发生的预测因子。
Objective To explore the incidence and embryo factors of blighted ovum in twin pregnancies achieved by assisted reproductive technology(ART)under controlling for maternal factors by vanishing twin.Methods A retrospective analysis was conducted in 610 cases of twin pregnancies achieved by IVF/ICSI twin transfer,who were treated in Nanfang Hospital of Southern Medical University from Jan. 2012 to Jan. 2018,including 474 twin live-birth pregnancies and 136 blighted ovum with singleton live-birth pregnancies. The clinical data of the 2 groups were analyzed for comparisons of the maternal factors,including maternal age,paternal age,BMI,AFC,bFSH/bLH and so on,and embryonic factors,like methods of fertilization,embryo types,proportion of high-quality embryos on DAY3 and so on.Results There was statistical difference in the serum β-hCG and rate of blastocyst transfer betweeen the two groups(P<0.05). No significant difference was found in the maternal factors among the 2 groups,such as maternal age,paternal age,BMI,AFC,bFSH/bLH,duration of infertility and so on(P>0.05). Also methods of fertilization,proportion of high-quality embryos on DAY3 and FET cycles were not statistically different between 2 groups.Multifactor Logistic regression analysis showed that blastocyst transfer was the risk factor of blighted ovum(OR=19.386,P<0.05),and β-hCG level was the protective factor(OR=0.290,P<0.05).Conclusion Studying blighted ovum with singleton live birth pregnancies,a kind of vanishing twin syndrome,can control blighted ovum-related maternal factors. Blastocyst transfer may increase the risk of blighted ovum,and low β-hCG level is the predictor of the incidence of blighted ovum.
作者
欧莹
华芮
全松
OU Ying;HUA Rui;QUAN Song(Center of Assistant Reproduction,Nanfang Hospital of Southern Medical University,Guangzhou 510515,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2019年第6期693-697,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家重点研发计划(2016YFC1000205)
中华医学会临床医学科研专项资金-生殖医学青年医师研究与发展项目(16020170633)
关键词
辅助生殖技术
枯萎卵
消失双胎
囊胚期胚胎移植
assisted reproductive technology
blighted ovum
vanishing twin
blastocyst transfer
