全囊胚培养在高龄低储备不孕患者中的应用分析

发布时间：2018-08-07 19:33

【摘要】：【目的】探讨全囊胚培养是否能使高龄低储备不孕患者获益。【方法】回顾性分析2016年5月至2017年4月于中山大学附属第六医院生殖医学研究中心就诊,采用IVF/ICSI助孕的高龄低储备不孕患者。根据第3天(D3)可移植胚胎的处理方式分为全养囊胚组(A组)及不养囊胚组(B组),比较两组的累积生化妊娠率,累积临床妊娠率。【结果】一共纳入符合条件的231名患者进行统计,A组130名,B组101名。两组患者的基本情况无差异。A组的累积生化妊娠率/临床妊娠率高于B组,差异无统计学意义(P0.05)。剔除A组中因无囊胚形成而最终未行胚胎移植的患者后,A组的累积生化妊娠率/临床妊娠率显著优于B组(P0.05)。对患者基本情况与培养囊胚结局的多因素分析结果显示:D3可移植胚胎数少是培养囊胚失败的危险因素(OR=0.277,95%CI为0.103~0.744,P0.05)。【结论】高龄低储备不孕患者行全囊胚培养不会对妊娠结局造成不利影响。相反,只要培养成囊胚可供移植,囊胚培养组的妊娠结局优于不养囊胚组;D3可移植胚胎数量少是培养囊胚失败的危险因素。在对患者进行充分地知情告知后,我们可酌情考虑对部分高龄低储备不孕患者行全囊胚培养。
[Abstract]:[objective] to explore whether the whole blastocyst culture can benefit the elderly patients with low reserve infertility. [methods] A retrospective analysis was made at the Reproductive Medicine Research Center of the sixth affiliated Hospital of Sun Yat-sen University from May 2016 to April 2017. The elderly patients with low reserve infertility who were assisted by IVF/ICSI. According to the treatment of D3 transferable embryos, they were divided into two groups: group A and group B, respectively. The cumulative biochemical pregnancy rates were compared between the two groups. Cumulative clinical pregnancy rate. [results] A total of 231 eligible patients were enrolled in this study, 130 patients in group A and 101 patients in group B were enrolled. The cumulative biochemical pregnancy rate / clinical pregnancy rate in group A was higher than that in group B (P0.05). The cumulative biochemical pregnancy rate and clinical pregnancy rate in group A were significantly better than those in group B (P0.05). The multivariate analysis of the basic condition of the patient and the outcome of the blastocyst culture showed that the low number of the embryos transfered into the blastocyst was the risk factor of the failure of blastocyst culture (ORX 0.277% 95 CI = 0.103 0. 744% P0.05). [conclusion] the whole blastocyst culture in the aged and low reserve infertility patients will not affect the pregnancy. The outcome of pregnancy has an adverse effect. On the contrary, the pregnancy outcome of blastocyst culture group was better than that of non-cultured blastocyst group, so long as the blastocyst culture was available for transplantation, the low number of D3 transferable embryos in blastocyst culture group was the risk factor for the failure of blastocyst culture. After informed patients, we may consider the use of full blastocyst culture in some elderly patients with low reserve infertility.
【作者单位】：中山大学附属第六医院生殖医学研究中心;
【基金】：国家重点研发计划(2017YFC1001603)
【分类号】：R714.8

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