冻融胚胎移植中辅助孵化对妊娠结局及安全性的影响

发布时间：2018-08-30 20:05

【摘要】：目的探讨在玻璃化冻融胚胎移植(FET)中,激光辅助孵化(AH)操作后对妊娠结局及母儿安全性的影响。方法回顾性分析2014年1月—2015年10月接受体外受精-胚胎移植(IVF-ET)失败后行FET患者的临床资料,根据患者年龄进行分组后比较AH操作后妊娠结局及母儿并发症的发生情况。结果在正常年龄组(38岁)的患者中,未行AH操作的对照组中胚胎种植率、临床妊娠率、活产率、多胎率均高于AH组,流产率低于AH组,并且差异有统计学意义(P0.05);在高龄(≥38岁)患者中,AH组的胚胎种植率、临床妊娠率较对照组有增高的趋势(P0.05);分娩周期中,AH组与对照组早产率、死胎率、母体并发症、新生儿男女比例、胎龄、出生体质量、新生儿缺陷率等均无统计学差异(P0.05)。结论对于正常年龄患者,卵裂期FET时不建议行AH操作;对于高龄患者,AH操作可提高胚胎种植率及临床妊娠率,但不能明显改善其妊娠结局;AH对母儿安全暂无不良影响。
[Abstract]:Objective to investigate the effect of laser assisted hatching (AH) on pregnancy outcome and maternal and fetal safety in vitrified freeze-thawed embryo transfer (FET). Methods the clinical data of patients undergoing FET after failure of in vitro fertilization and embryo transfer (IVF-ET) from January 2014 to October 2015 were analyzed retrospectively. The pregnancy outcome and maternal and fetal complications after AH operation were compared according to the age of the patients. Results in the normal age group (38 years), the embryo implantation rate, clinical pregnancy rate, live birth rate, multiple births rate and abortion rate in the control group without AH were higher than those in the AH group, and the abortion rate was lower than that in the AH group. And the difference was statistically significant (P0.05); the embryo implantation rate and clinical pregnancy rate of AH group were higher than those of control group (P0.05); the premature delivery rate, stillbirth rate, maternal complications in AH group and control group were higher than those in control group (P0.05). There was no significant difference in the ratio of male and female newborns, gestational age, birth weight and neonatal defect rate (P0.05). Conclusion for normal age patients, AH is not recommended for FET during cleavage, and AH can increase embryo implantation rate and clinical pregnancy rate in elderly patients, but can not obviously improve the pregnancy outcome. There is no adverse effect on the safety of mother and fetus.
【作者单位】：同济大学附属第一妇婴保健院生殖医学中心;
【分类号】：R714.8

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