摘要
目的探讨非优质胚胎囊胚培养是否为高效利用非优质胚胎的最佳选择,为制定更利于患者的助孕方案提供参考。方法选择2015年12月至2016年12月在中国医科大学附属盛京医院辅助生殖中心接受体外受精-胚胎移植(IVF-ET)或卵胞浆内单精子显微注射-胚胎移植(ICSI-ET)的不孕患者308例。第3天无优质胚胎形成,按患者意愿分为两组:卵裂期移植组(196例)及囊胚培养组(112例)。比较两组累积临床妊娠率、种植率、流产率、治疗成本、移植周期。结果卵裂期移植组与囊胚培养组的种植率(26.4%vs.44.3%)、周期数[每例患者(1.12±0.37)个vs.(0.86±0.45)个]、治疗成本[每例患者(4433.67±2027.10)元vs.(4750.97±2067.06)元]比较,差异均有统计学意义(P<0.05)。累积临床妊娠率(49.5%vs.44.6%)、流产率(4.1%vs.2.0%)比较,差异均无统计学意义(P>0.05)。囊胚培养组具有较高的周期取消率。卵裂期移植组第3天胚胎数≥5枚的累积临床妊娠率显著高于囊胚培养组(81.6%vs.53.6%),差异有统计学意义(P<0.05)。结论囊胚培养并不是高效利用非优质胚胎的最佳选择;卵裂期胚胎形态学评估预测胚胎植入潜能作用有限。
Objective To discuss if the blastocyst culture of poor-quality embryos to blastocyst stage was the best choice for these patients who didn＇t obtain good-quality embryos in one IVF-ET/ICSI-ET cycle and to provide a reference for making a better cheme of assisting pregnancy.Methods The date of this retrospective study collected between December 2015 and December 2016,at the infertility clinic of Shengjing Hospital,China Medical University.All the couples included in the study had low-quality embryos on the day of fresh embryo transfer（day 3）.according to their willingness to divide the patients into two groups： cleavage stage transplantation group（n=196）and blastocyst culture group（n=112）. Comparing between the two groups of the cumulative clinical pregnancy rate,implantation rate,abortion rate,treatment costs and repeated cycles.Results Significant difference was found in implantation rate（26.4% vs. 44.3%）,repeated cycles[（1.12±0.37）times/person vs.（0.86±0.45）times/person],and treatment costs[（4433.67±2027.10）Yuan/person vs.（4750.97±2067.06）yuan/person]（P〈0.05）.No significant difference was found in cumulative clinical pregnancy rate（49.5% vs. 44.6%）or abortion rate（4.1% vs. 2.0%）（P〉0.05）. Blastocyst culture group had higher cycle cancellation rate.In patients obtaining more than 5 embryos on the third day,the cumulative clinical pregnancy rate of cleavage-stage culture group was significantly higher than that of blastocyst culture group（81.6% vs. 53.6%）（P〈0.05）.Conclusion The blastocyst culture is not the best choice for using poor-quality embryos efficiently.The evaluation of cleavage-stage embryo morphology plays a limited role in predicting the potential of embryo implantation.
作者
王天然
王秀霞
焦娇
WANG Tian-ran;WANG Xiu-xia;JIAO Jiao(Center of Reproductive Medicine, Shengjing Hospital, China Medical University, Shenyang 110004, China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2018年第6期645-649,共5页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
非优质胚胎
囊胚培养
累积妊娠率
种植率
治疗成本
poor-quality embryos
blastocyst culture
the cumulative pregnancy rate
implantation rate
treatment costs
作者简介
通讯作者：王秀霞，电子信箱：wangxx@sj-hospital．org
