鲜胚移植结果对随后冻胚移植结局的预测价值
发布时间：2018-08-27 09:32
【摘要】：目的研究体外受精-胚胎移植(IVF-ET)中,来自同一促排卵周期的卵子所形成胚胎的临床结局,分析鲜胚移植和再次行冻胚移植临床结局的相关性,探讨同一簇来源卵子的发育潜能。方法以2012年1月-2015年3月期间,在宁夏医科大学总院生殖医学中心实施IVF/ICSI鲜胚移植及其随后又行冻融胚胎移植的所有患者为研究对象。纳入标准:1.排卵功能正常(超声监测合并黄体期孕酮水平检测证实);2.不孕病因为输卵管因素、男方因素;3.卵巢储备功能正常CD3:FSH15IU/ml。排除赠卵周期和来源于不同周期胚胎的患者。所有的患者均采用长方案促排卵,降调满意后给予重组卵泡刺激素(rFSH)150-450IU/d启动,至卵泡直径至少2个≥18mm,肌注人绒毛膜促性腺激素(hCG),36h后取卵。根据鲜胚移植后妊娠结局分为两组,A组是鲜胚移植后妊娠,因流产或计划二胎等原因继而又行冻融胚胎移植,B组是鲜胚移植后未妊娠再次行冻融胚胎移植,比较A组和B组冻融胚胎移植周期(FET)的临床妊娠率和活产率。结果鲜胚妊娠组患者冷冻胚胎数(P=0.016)、优质胚胎数(P=0.001)、优质胚胎率(P=0.01)均高于鲜胚未妊娠组,差异均有统计学意义(P0.05)。在冻融胚胎周期中,A组临床妊娠率62.5%显著高于B组临床妊娠率44.0%,差异有统计学意义(P0.05)。A组患者活产率55.36%高于B组活产率38.67%,但是P=0.111,差异无统计学意义。结论同一促排周期获得的卵子形成的胚胎,鲜胚移植成功妊娠的患者在冻胚周期有着更高的临床妊娠率,提示同一簇来源的卵子有着相似的发育潜能,即鲜胚移植周期成功妊娠对其随后冻胚移植结局有积极的预测价值。
[Abstract]:Objective to study the clinical outcome of oocyte formation from the same ovulatory cycle in vitro fertilization-embryo transfer (IVF-ET), to analyze the correlation between the clinical outcome of fresh embryo transplantation and that of frozen embryo transfer, and to explore the developmental potential of eggs from the same cluster. Methods from January 2012 to March 2015, all the patients who underwent IVF/ICSI fresh embryo transplantation and then frozen-thawed embryo transfer in the Center of Reproductive Medicine, General Hospital of Ningxia Medical University were studied. Inclusion criterion: 1. Normal ovulation function (confirmed by ultrasound monitoring combined with progesterone level in luteal phase). The cause of infertility is fallopian tube factor, male factor is 3. Normal ovarian reserve CD3:FSH15IU/ml. Patients with egg donation cycles and embryos from different cycles were excluded. All the patients were induced to ovulation with a long regimen, and were treated with recombinant follicle stimulating hormone (rFSH) 150-450IU/d) at least 2 or more than 18mm in follicle diameter. The oocytes were obtained by intramuscular injection of human chorionic gonadotropin (hCG) for 36 h. According to the pregnancy outcome of fresh embryo transplantation, group A was divided into two groups: group A was pregnant after fresh embryo transfer, and then frozen and thawed embryo transfer was carried out for reasons such as abortion or planned second embryo. Group B was frozen and thawed embryo transfer without pregnancy after fresh embryo transfer. The clinical pregnancy rate and live delivery rate of (FET) in group A and group B were compared. Results the number of frozen embryos (P0. 016), the number of high quality embryos (P0. 001) and the rate of high quality embryos (P0. 01) in fresh embryo pregnancy group were significantly higher than those in fresh embryo group (P0.05). In the frozen-thawed embryo cycle, the clinical pregnancy rate of group A was significantly higher than that of group B (44.0%). The difference was statistically significant (P0.05). The living rate of group A was 55.36% higher than that of group B (38.67%), but the difference was not statistically significant. Conclusion the embryos obtained from the same ovulation promoting cycle have higher clinical pregnancy rate in the frozen embryo cycle, indicating that the eggs from the same cluster have similar developmental potential. That is, the successful pregnancy of fresh embryo transfer cycle has positive predictive value for the outcome of frozen embryo transplantation.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R714.8
，
本文编号：2206871
[Abstract]:Objective to study the clinical outcome of oocyte formation from the same ovulatory cycle in vitro fertilization-embryo transfer (IVF-ET), to analyze the correlation between the clinical outcome of fresh embryo transplantation and that of frozen embryo transfer, and to explore the developmental potential of eggs from the same cluster. Methods from January 2012 to March 2015, all the patients who underwent IVF/ICSI fresh embryo transplantation and then frozen-thawed embryo transfer in the Center of Reproductive Medicine, General Hospital of Ningxia Medical University were studied. Inclusion criterion: 1. Normal ovulation function (confirmed by ultrasound monitoring combined with progesterone level in luteal phase). The cause of infertility is fallopian tube factor, male factor is 3. Normal ovarian reserve CD3:FSH15IU/ml. Patients with egg donation cycles and embryos from different cycles were excluded. All the patients were induced to ovulation with a long regimen, and were treated with recombinant follicle stimulating hormone (rFSH) 150-450IU/d) at least 2 or more than 18mm in follicle diameter. The oocytes were obtained by intramuscular injection of human chorionic gonadotropin (hCG) for 36 h. According to the pregnancy outcome of fresh embryo transplantation, group A was divided into two groups: group A was pregnant after fresh embryo transfer, and then frozen and thawed embryo transfer was carried out for reasons such as abortion or planned second embryo. Group B was frozen and thawed embryo transfer without pregnancy after fresh embryo transfer. The clinical pregnancy rate and live delivery rate of (FET) in group A and group B were compared. Results the number of frozen embryos (P0. 016), the number of high quality embryos (P0. 001) and the rate of high quality embryos (P0. 01) in fresh embryo pregnancy group were significantly higher than those in fresh embryo group (P0.05). In the frozen-thawed embryo cycle, the clinical pregnancy rate of group A was significantly higher than that of group B (44.0%). The difference was statistically significant (P0.05). The living rate of group A was 55.36% higher than that of group B (38.67%), but the difference was not statistically significant. Conclusion the embryos obtained from the same ovulation promoting cycle have higher clinical pregnancy rate in the frozen embryo cycle, indicating that the eggs from the same cluster have similar developmental potential. That is, the successful pregnancy of fresh embryo transfer cycle has positive predictive value for the outcome of frozen embryo transplantation.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R714.8
，
本文编号：2206871
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