摘要
目的探讨冻融囊胚的发育天数和质量对妊娠结局的影响。方法选取2018年8月至2020年1月在金华市人民医院生殖医学中心行冻融囊胚移植者的1425个周期,根据囊胚形成时间分为第5日组(D5组,874个周期)与第6日组(D6组,551个周期),比较两组种植率、临床妊娠率、早期流产率、异位妊娠率和多胎妊娠率等妊娠结局指标。再根据移植囊胚质量和个数将D5/D6组分为单优质囊胚移植组、优质囊胚+非优质囊胚移植组和双非优质囊胚移植组,比较3组妊娠结局指标。结果D5组种植率和临床妊娠率均高于D6组,且早期流产率低于D6组,差异均有统计学意义(均P<0.05);但两组异位妊娠率和多胎妊娠率比较差异均无统计学意义(均P>0.05)。D5组中,单优质囊胚移植组种植率高于优质囊胚+非优质囊胚移植组和双非优质囊胚移植组(均P<0.0167);优质囊胚+非优质囊胚移植组临床妊娠率高于单优质囊胚移植组,但多胎妊娠率也高于单优质囊胚移植组(均P<0.0167);双非优质囊胚移植组早期流产率高于单优质囊胚移植组(P<0.0167)。D6组中,单优质囊胚移植组和优质囊胚+非优质囊胚移植组种植率均高于双非优质囊胚移植组(均P<0.0167);优质囊胚+非优质囊胚移植组临床妊娠率高于单优质囊胚移植组,但多胎妊娠率也高于单优质囊胚移植组(均P<0.0167);单优质囊胚移植组和优质囊胚+非优质囊胚移植组早期流产率均低于双非优质囊胚移植组(均P<0.0167)。结论囊胚发育速度和囊胚质量均可影响囊胚移植后的临床妊娠结局。建议优先移植D5囊胚,行单优质囊胚移植和双非优质囊胚移植。可以在保证获得临床妊娠的同时,尽量减少多胎妊娠的风险。
Objective To explore the influence of development day and quality of frozen-thawed blastocysts on pregnancy outcomes.Methods Clinical data of 1425 patients with frozen-thawed blastocyst transfer in the reproductive center of Jinhua People’s Hospital from August 2018 to January 2020 were retrospectively analyzed.According to frozen day the patients were divided into D5 frozen group(n=874)and D6 frozen group(n=551).The pregnancy outcomes including implantation rate,clinical pregnancy rate,early abortion rate,ectopic pregnancy rate and multiple pregnancy rate were compared between two groups.According to the quality and number of blastocyst transfer,each group was further divided into three subgroups:single high quality blastocyst transfer,high quality blastocyst+non-high quality blastocyst transfer and double non-high quality blastocyst transfer.The pregnancy outcomes were also compared.Results The implantation rate,clinical pregnancy rate and early abortion rate of D5 group were significantly better than those of D6 group(all P<0.05),while there were no significant differences in ectopic pregnancy rate and multiple pregnancy rate between two groups(both P>0.05).In D5 group,the implantation rate of single high quality blastocyst transfer was significantly higher than that of high quality blastocyst+non-high quality blastocyst transfer and double non-high quality blastocyst transfer(both P<0.0167).The clinical pregnancy rate of high quality blastocyst+non-high quality blastocyst transfer was higher than that of single high quality blastocyst transfer,but the multiple pregnancy rate was also significantly higher than that of single high quality blastocyst transfer(both P<0.0167),and the early abortion rate of double non-high quality blastocyst transfer was significantly higher than that of single high quality blastocyst transfer and high quality blastocyst+non-high quality blastocyst transfer(both P<0.0167).In D6 group,single high quality blastocyst transfer had the highest implantation rate and the lowest early ab
作者
柴娟
余柯达
包云
师帅
邹立波
CHAI Juan;YU Keda;BAO Yun;SHI Shi;ZOU Libo(Center of Reproductive Medicine,Jinhua People’s Hospital,Jinhua 321000,China)
出处
《浙江医学》
CAS
2020年第17期1847-1851,共5页
Zhejiang Medical Journal
基金
金华市科学技术研究计划项目(2019-4-026、2019-4-036)。
关键词
囊胚移植
第5日囊胚
第6日囊胚
妊娠结局
Blastocyst transfer
D5 blastocyst
D6 blastocyst
Pregnancy outcomes
