摘要
目的探讨D 3胚胎移植后剩余胚胎行囊胚培养,有无囊胚形成对临床结局的预测,寻找最佳的胚胎移植策略,为提高体外受精-胚胎移植(IVF-ET)的临床结局提供理论依据。方法回顾性研究分析2016年1月至2018年5月在郑州大学第一附属医院生殖医学中心行IVF-ET并于D 3移植2枚优质胚胎且有剩余优质胚胎行囊胚培养的3568例患者,根据年龄分为<35岁组、35〜38岁组、>38岁组,又根据有无囊胚形成,分为两个亚组:有囊胚形成组、无囊胚形成组,比较各组内胚胎发育及临床结局情况。结果(1)比较第1周期患者3个年龄段组胚胎发育情况,3组中有囊胚形成组总受精率、正常受精率、卵裂率、优质胚胎率均高于无囊胚形成组,差异有统计学意义,P<〇.〇5;<35岁组,有囊胚形成组胚胎利用率(75.0%比70.6%)、妊娠率(74.9%比70.3%)、种植率(53.6%比48.6%)、分娩率(66.7%比61.1%)、活产率(66.5%比61.0%)均高于无囊胚形成组,户<0.05。(2)比较多周期(S 2周期)患者3个年龄段胚胎发育情况,<35岁组中,有囊胚形成组总受精率(75.0%比70.6%)、分娩率(62.7%比43.8%)、活产率(62.7%比43.8%)明显高于无囊胚形成组,P<0.05;在>38岁组中,有囊胚形成组妊娠率(56.3%比25.8%)、种植率(34.4%比14.5%)、分娩率(43.8%比11.3%)、活产率(43.8%比11.3%)高于无囊胚形成组,P<0.05。结论不同年龄段囊胚培养结果可预测D3胚胎移植助孕结局。对于第1周期<35岁患者,D3移植后有囊胚形成组的临床结局要优于无囊胚形成组,多周期(>2周期)患者,<35岁、>38岁两组患者有囊胚形成组的临床结局优于无囊胚形成组。
Objective To find the best strategy of embryo transfer, so as to provide theoreticalbasis for improving the clinical outcomes of in vitro fertilization-Embryo transfer (IVF-ET), we investigate theblastocyst culture of surplus cleavage-stage embryos after D3 embryo transfer and the prediction of clinicaloutcomes with or without blastocyst formation. Methods A retrospective study was conducted on 3 568patients who underwent IVF-ET in the Reproductive Medicine Center of the First Affiliated Hospital ofZhengzhou University from January 2016 to May 2018, whotransplanted two embryos in D3 with blastocystculture of surplus cleavage-stage embryos, according to their age, they were divided into three groups: <35years old group, 35-38 years old group, and>38 years old group.And according to the presence or absence ofblastocyst formation, they were also divided into two subgroups: blastocyst formation group andnon-blastocyst formation group. The embryo development and clinical outcomes in each group werecompared. Results (1) Comparisons of the embryo development in the three age groups with the first cycle.The total fertilization rate, cleavage rate and high quality embryo rate of the blastocyst formation group in thethree groups were higher than those in the non-blastocyst formation group, P<0.05;In<35 years old group,the embryo utilization rate (75.0% vs 70.6%), pregnancy rate (74.9% vs 70.3%), planting rate (53.6% vs48.6%), delivery rate (66.7% vs 61.1%) and live birth rate (66.5% vs 61.0%) of the blastocyst formation group were higher than those in the non-blastocyst formation group, P<0.05. (2) Comparisons of embryodevelopment in the three age groups with multiple cycles (^2 cycles). In<35 years old group, the totalfertilization rate (75.0% vs 70.6%),delivery rate (62.7% vs 43.8%) and live birth rate (62.7% vs 43.8%) ofthe blastocyst formation group were significantly higher than those in the non-blastocyst formation group, P<0.05;In>38 years old group, the pregnancy rate (56.3% vs 25.8%), implantation rate (34.4% vs 14.5%),delivery rate (43.8% vs 11.3%), live birth rate (43.8% vs 11.3%) of the blastocyst formation group werehigher than those in the non-blastocyst formation group, P<0.05. Conclusions The results of blastocystculture in different groups can predict the outcomes of embryo transfer in D3. For patients<35 years old withthe first cycle, the clinical outcomes of the blastocyst formation group after D3 embryo transfer is better thanthat of the non-blastocyst formation group. For Patients with multiple cycles (^2 cycles),the clinical outcomesof the embryo formation group is superior to that of the non-blastocyst formation group<35 years old or>38years old.
作者
金海霞
王赛赛
宋文妍
戴善军
李刚
姚桂东
石森林
刘艳
张福利
Jin HaixiaWang Saisai;Song Wenyan;Dai Shanjun;Li Gang;Yao Guidong;Shi Senlin;Liu Yan;Zhang Fuli(Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2019年第46期3627-3632,共6页
National Medical Journal of China
关键词
卵裂期胚胎
胚胎移植
妊娠结局
囊胚
Cleavage-stage embryo
Embryo transfer
Pregnancy outcome
Blastocyst
作者简介
通信作者:金海霞,Email:jinhx@zzu.edu.cn。
