摘要
目的探讨≤35岁、36~37岁及≥38岁患者,在移植2枚卵裂期胚胎时临床妊娠率、胚胎着床率、活产率、妊娠天数及新生儿体重等的差异.方法回顾性分析2012年1月1日至2016年12月31日,第一次在浙江大学医学院附属邵逸夫医院生殖中心接受常规长或短方案体外受精/卵母细胞质内单精子注射-胚胎移植(IVF/ICSI-ET)治疗,移植2枚胚龄为3d胚胎的新鲜周期资料,共3295个周期.按患者年龄分为三组:≤35岁(A组)、36~37岁(B组)及≥38岁(C组),比较三组间的临床妊娠率、胚胎着床率、流产率、活产率等临床结局,以及新生儿体重、早产率、多胎率、新生儿性别比例等新生儿结局差异.结果三组临床妊娠率、胚胎着床率、早产率(<37周)及活产率差异均有统计学意义(P<0.01).A组的临床妊娠率与活产率显著高于C组(P<0.05),但与B组无明显差异(P>0.05),而A组的胚胎着床率与多胎妊娠率则显著高于B组与C组(P>0.05),此外,A组的早产率显著低于C组(P<0.05),但与B组无明显差异(P>0.05).三组早期流产率、晚期流产率、妊娠天数、胎儿性别比例、胎儿体重及低出生体重儿比率上差异均无统计学意义(P>0.05).再将三组根据移植胚胎的质量进行分组比较.当移植的两个胚胎均为优质胚胎时,A组与B组在临床妊娠率、胚胎着床率与活产率上无明显差异,均显著高于C组.但三组在流产率与多胎率上无明显差异.当移植的两个胚胎为一个优质胚胎和一个普通胚胎时,A组的临床妊娠率、胚胎着床及活产率显著高于B组及C组(P<0.05).但三组在早产率、妊娠天数、胎儿性别比例、胎儿体重及低出生体重儿比率上均无显著差异(P>0.05).结论对于年龄≥38岁的高龄女性患者移植两个胚胎可保持较好的妊娠率、着床率及活产率.而对于年龄36~37岁的高龄女性患者,需要综合考虑胚胎质量来决定移植胚胎个数,可选择单优质胚胎移植或优质胚�
Objective To investigate the difference of clinical pregnancy rate,embryo implantation rate,live birth rate,gestational days and neonatal weight of patients≤35 years old(Group A),36〜37 years old(Group B)and≥38 years old(Group C).Methods A total of 3295 double cleavage embryo transfer cycles between January 2012 and December 2016 at Affiliated Sir Kun Run Shaw Hospital,Zhejiang University were analyzed.All cycles were categorized into three groups according to patients'age:W35years(Group A),36~37 years(Group B)and M38 years(Group C).The clinical pregnancy rate(CPR),implantation rate(IR),live birth rate(LBR),miscarriage rate,multiple pregnancy rate(MPR),preterm birth rate and low birth weight rate were compared.Results There were significant differences in CPR,IR,preterm birth rate(<37weeks)and LBR among the three groups(P<0.01).The results showed that the CPR and LBR of group A were significantly higher than those of group C(P<0.05),but there was no significant difference between group A and group B(P>0.05).And the IK and MPI<of group A were significantly higher than those of group B and group C(P>0.05).In addition,the pretemi birth rate of group A was significantly lower than that of group C(P<0.05),but there was no difference between group A and group B(P>0.05).There were no significant differences in early miscarriage rate,late miscarriage rate,pregnancy days,sex ratio of fetus,fetal weight and low birth weight rate among three groups(P>0.05).Moreover,the three groups were fiirther compared according to the quality of embryo transferred.When the two embryos transferred were both of high quality,there was no significant difference in CPR,IR and LBR between group A and group B,which was significantly higher than that of group C.But there was no difference in miscarriage rate and MPR among the three groups.When the two embryos transferred included only one high-quality embryo,the CPR,IR and LBR of group A were significantly higher than those of group B and group C(P<0.05).However,there were no significant di
出处
《浙江临床医学》
2020年第8期1079-1081,共3页
Zhejiang Clinical Medical Journal
基金
国家重点研发项目(2018YFC1004800)
国家自然科学基金资助项目(81601236)
浙江省自然科学基金项目(LY19H040009)。
关键词
高龄
卵裂期胚胎
胚胎移植
临床结局
新生儿结局
Advanced age
Cleavage embryo
Embryo transfer
Clinical outcome
Neonatal outcome
