D3仅一枚优质胚胎患者新鲜周期不同移植方案的临床结局分析

发布时间：2018-05-16 12:21

本文选题：优质胚胎 + 移植方案　；参考：《现代妇产科进展》2017年11期

【摘要】：目的:探讨D3仅一枚优质胚胎患者新鲜周期不同移植方案的临床结局。方法:回顾分析2014年1月至2016年12月在山东大学附属生殖医院接受体外受精-胚胎移植(IVF-ET)治疗周期的第3天(D3)仅一枚优质胚胎的3286例患者,其中2677例新鲜周期移植。根据正常受精数分为3组:A组仅有一枚正常受精胚胎;B组仅有两枚正常受精胚胎;C组大于两枚正常受精胚胎。将3组患者按移植方案再分为3组:第三天移植一枚卵裂期胚胎(D3-1组);第三天移植两枚卵裂期胚胎(D3-2组);第五天移植一枚囊胚(D5-1组)。分别比较3组患者不同移植方案的临床结局。结果:A组中,D3-1组和D5-1组的临床妊娠率、胚胎着床率、早期流产率、多胎妊娠率方面均无显著差异(P0.05);B组中,D3-2组的临床妊娠率和多胎妊娠率均高于D3-1组(48.59%vs 33.73%,19.88%vs0,P0.01);C组中,D3-2组的临床妊娠率和多胎妊娠率均高于D3-1组(52.88%vs 40.24%,34.34%vs 0,P0.01),D3-2组的胚胎着床率低于D5-1组(34.95%vs 46.43%,P0.01),D3-2组的多胎妊娠率高于D5-1组(34.34%vs 1.56%,P0.01);D5有优质囊胚形成周期占比方面:C组高于A组和B组(68.93%vs 46.70%和56.67%,P0.01);放弃周期率方面:C组低于A组和B组(13.79%vs 32.42%和28.0%,P0.01)。结论:对于D3仅一枚优质胚胎的患者,移植一枚胚胎可显著降低多胎妊娠率;D5移植降低了胚胎的利用效率;D3移植两枚卵裂期胚胎比移植一枚卵裂期胚胎可获得更高的临床妊娠率;当正常受精胚胎数大于两枚时,D5移植可以获得更高的种植率。
[Abstract]:Objective: to investigate the clinical outcome of D 3 with only one high quality embryo in fresh cycle. Methods: from January 2014 to December 2016, 3286 patients who received IVF-ET3 (IVF-ET3) treatment cycle from January 2014 to December 2016 were retrospectively analyzed. 2677 of them received fresh cycle transplantation. According to the number of normal fertilization, there was only one normal fertilized embryo in group A and only two embryos in group B were divided into three groups: group C was larger than group C, and group C was more than two normal fertilized embryos. The three groups were divided into three groups according to the transplant plan: group D3-1, group D3-2, and group D5-1, one blastocyst were transplanted on the fifth day. The clinical outcomes of three groups of patients with different transplantation schemes were compared. Results the clinical pregnancy rate, embryo implantation rate, early abortion rate of D3-1 group and D5-1 group were analyzed. There was no significant difference in the rate of multiple pregnancy. The clinical pregnancy rate and the multiple pregnancy rate of D3-2 group were higher than that of D3-1 group 48.59 vs 33.73x19.88 vs 19.88 vs0. 01, and the clinical pregnancy rate and multiple pregnancy rate of D3-2 group were higher than that of D3-1 group (52.88 vs 40.24 vs 34.34 vs 0P0.01 D3-2). The embryo implantation rate of D3-2 group was lower than that of D3-2 group. The rate of multiple pregnancies in group D5-1 was higher than that in group D5-1 (34.34 vs 1.56.1%). The percentage of high quality blastocysts in group C was higher than that in group C (68.93% vs 46.70% and 56.67P 0.01), and the rate of abandonment in group C was lower than that in group A and group B (13.79 vs 32.42% and 28.0%). Conclusion: for D3 patients with only one high-quality embryo, Transfer of one embryo could significantly reduce the rate of multiple pregnancy and the efficiency of D5 transfer could decrease the efficiency of embryo utilization. The clinical pregnancy rate of two cleavage embryos was higher than that of one cleavage embryo. When the number of normal fertilized embryos was more than two, the implantation rate of D5 was higher than that of normal fertilized embryos.
【作者单位】：山东大学附属生殖医院;
【基金】：国家自然科学基金面上项目(No:81671413) 国家重点研发计划(No:2016YFC1000604)
【分类号】：R714.8

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