摘要
目的探讨拮抗剂方案单胚胎移植的临床应用价值。方法回顾性队列研究分析2017年1月至2021年3月期间在中国人民解放军联勤保障部队第901医院生殖医学中心行拮抗剂方案体外受精/卵胞质内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕患者的临床资料,根据胚胎发育时间和移植胚胎数分为第3日(day 3,D3)单优质卵裂胚移植组(单优组),D3双优质卵裂胚移植组(双优组)和单囊胚移植组(单囊胚组)。其中新鲜周期单优组301个周期、双优组253个周期、单囊胚组127个周期;冻融胚胎移植(frozen-thawed embryo transfer,FET)周期单优组84个周期、双优组136个周期、单囊胚组396个周期;全胚冷冻首次FET单优组69个周期、单囊胚组161个周期。采用单因素方差分析及卡方检验比较新鲜和FET周期单优组、双优组、单囊胚组及首次FET周期单优组与单囊胚组的临床妊娠率、种植率、多胎妊娠率、早期流产率、持续妊娠率。结果各组不孕年限、体质量指数(body mass index,BMI)、基础卵泡刺激素(follicle-stimulating hormone,FSH)、基础黄体生成素(luteinizing hormone,LH)、基础雌二醇、抗苗勒管激素(anti-Müllerian hormone,AMH)、促性腺激素(gonadotropin,Gn)用量、获卵数差异均无统计学意义(均P>0.05),新鲜周期中单优组的临床妊娠率、种植率、多胎妊娠率、早期流产率、持续妊娠率与新鲜周期单囊胚组比较差异均无统计学意义(均P>0.05),临床妊娠率[46.18%(139/301)]、持续妊娠率[40.86%(123/301)]、多胎妊娠率[0%(0/139)]显著低于双优组[58.89%(149/253),P<0.001;52.17%(132/253),P<0.001;30.20%(45/149),P<0.001],种植率与双优组比较差异无统计学意义(P>0.0167)。FET中单优组的临床妊娠率、种植率、持续妊娠率与双优组比较差异均无统计学意义(均P>0.0167),但均显著低于单囊胚组[62.88%(249/396),P<0.001;63.89%(253/396),P<0.001;55.30%(219/396),P<0.001]
Objective To investigate the clinical value of single embryo transfer for the patients with gonadotropin-releasing hormone(GnRH)antagonist protocol.Methods The clinical data of the patients underwent in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)in Reproductive Medicine Center,the 901th Hospital of the Joint Logistics Support Force of PLA from January 2017 to March 2021 were retrospectively analyzed in this cohort study.According to the days of embryo development and No.of embryos,patients were divided into day 3(D3)single top-quality cleavage-stage embryo transfer group(single top-quality embryo group),D3 double top-quality cleavage-stage embryo transfer group(double top-quality embryos group),and single blastocyst transfer group.In fresh cycles,there were 301 patients in single top-quality embryo group,253 patients in double top-quality embryos group and 127 patients in single blastocyst group in frozen-thawed embryo transfer(FET)cycles,there were 84 patients in single top-quality embryo group,136 patients in double top-quality embryos group and 396 patients in single blastocyst group in first FET cycles after all embryos frozen,there were 69 patients in single top-quality group and 161 patients in single blastocyst group.The rates of clinical pregnancy,implantation,multiple pregnancy,early abortion and ongoing pregnancy in the fresh and FET cycles were compared among single top-quality embryo group,double top-quality embryos group and single blastocyst group.Also,the rates of clinical pregnancy,implantation,multiple pregnancy,early abortion and ongoing pregnancy of single top-quality embryo transfer and single blastocyst transfer were compared between the fresh cycle and the first FET cycle.One-way ANOVA and chi-square test were used in this study.Results There were no significant difference in duration of infertility,body mass index(BMI),the levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol,anti-Müllerian hormone(AMH),gonadotropin(Gn)and the numbers of oocytes r
作者
栾康
姜宏
殷慧群
汪存利
朱杰
曹振毅
吴燕
Luan Kang;Jiang Hong;Yin Huiqun;Wang Cunli;Zhu Jie;Cao Zhenyi;Wu Yan(Reproductive Medicine Center,the 901th Hospital of the Joint Logistics Support Force of PLA,Hefei 230031,China)
出处
《中华生殖与避孕杂志》
CSCD
北大核心
2022年第2期125-131,共7页
Chinese Journal of Reproduction and Contraception
基金
安徽省科技攻关计划项目(1604a0802095)。
关键词
拮抗剂方案
单囊胚移植
单卵裂胚移植
临床结局
Antagonist protocol
Single blastocyst transfer
Single cleavage-stage embryo transfer
Clinical outcomes
