低等级囊胚与不同质量分裂胚冻融后妊娠结局的比较

发布时间：2018-02-21 16:31

本文关键词： 胚胎冷冻分裂胚囊胚种植率流产率多胎率　出处：《临床和实验医学杂志》2016年24期 　论文类型：期刊论文

【摘要】：目的比较冻胚移植周期低等级囊胚与不同质量分裂胚冻融移植后的妊娠结局,探讨不同时期和质量的胚胎的发育潜能,为临床冻融周期移植胚胎的选择策略提供参考。方法回顾性分析2015年1月至2016年6月冻胚移植周期患者临床资料,将同一新鲜周期中既有第三天冷冻分裂胚又在第五天仅有低等级囊胚冷冻者纳入研究。其中冷冻的分裂胚按照形态学评分标准分为顶级冷冻分裂胚和次级冷冻分裂胚。患者自愿选择分裂胚或第5天囊胚解冻,移植2枚胚胎。移植胚胎均为低等级囊胚者243周期,移植胚胎均为顶级分裂胚者156周期,移植胚胎均为次级分裂胚者114周期。比较三组胚胎的临床妊娠率、种植率、早期流产率和多胎率,进行统计学分析。结果顶级分裂胚与低等级囊胚的临床妊娠率和种植率相似(64.20%vs.64.74%,44.03%vs.46.79%),显著高于次级分裂胚(49.12%,35.48%);顶级分裂胚的早期流产率显著低于低等级囊胚和次级分裂胚(3.96%vs.8.33%,7.14%);多胎率方面,顶级分裂胚最高(44.55%),其次为低等级囊胚(37.18%)和次级分裂胚(32.46%),但流产率和多胎率的差异无统计学意义。结论冻胚移植周期中,顶级分裂胚与低等级囊胚相比,具有更好的妊娠结局,次级分裂胚的临床结局较差。当患者冷冻的囊胚只有低等级,而同时有分裂胚冷冻时,首选顶级分裂胚进行解冻和移植,其次为囊胚,最后为次级分裂胚。
[Abstract]:Objective to compare the pregnancy outcomes of frozen-thawed embryos with low-grade blastocysts and cleavage embryos of different quality in order to explore the developmental potential of embryos of different stages and quality. Methods the clinical data of patients with frozen embryo transfer cycle from January 2015 to June 2016 were retrospectively analyzed. The cryopreserved blastocysts of the same fresh cycle were divided into two groups according to the morphological score: the top frozen cleavage embryo and the second frozen blastocyst according to the morphological scoring criteria, and the cryopreserved blastocysts were only cryopreserved on the third day and only on the 5th day. Cleavage embryo. The patient voluntarily chooses to divide the embryo or thaw the blastocyst on the 5th day. Two embryos were transferred. 243 cycles of low-grade blastocysts, 156 cycles of top cleavage embryos and 114 cycles of secondary cleavage embryos were transferred. The clinical pregnancy rate and implantation rate of the three groups were compared. Early abortion and multiple births, Results the clinical pregnancy rate and implantation rate of the top and low grade blastocysts were similar to those of the top and low grade blastocysts. Results the clinical pregnancy rate and implantation rate of the top and lower grade blastocysts were similar to those of the top cleavage embryos, which were significantly higher than those of the secondary cleavage embryos. The early abortion rate of the top cleavage embryos was significantly lower than that of the lower grade blastocysts and the secondary division blastocysts 3.96vs.8.337.14.The rate of multiple births was significantly higher than that of the second grade blastocysts. The highest cleavage embryo was 44.55g, followed by the lower grade blastocyst (37.18) and the secondary division embryo (32.46), but there was no significant difference between the abortion rate and the multiple embryo rate. Conclusion in the frozen embryo transfer cycle, the top division embryo has a better pregnancy outcome than the low grade blastocyst. When the cryopreserved blastocysts were only of low grade and the cleavage embryos were frozen at the same time, the first choice was thawing and transplanting, the second was blastocyst, and the last was secondary cleavage embryo.
【作者单位】：江苏省南京市南京大学医学院附属鼓楼医院生殖医学中心;
【基金】：国家自然科学基金青年基金项目(编号:81601277) 南京市医学科技发展课题项目(编号:YKK15074)
【分类号】：R714.8

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