本文選題：優(yōu)質(zhì)胚胎 + 移植方案��； 參考：《現(xiàn)代婦產(chǎn)科進(jìn)展》2017年11期

【摘要】：目的:探討D3僅一枚優(yōu)質(zhì)胚胎患者新鮮周期不同移植方案的臨床結(jié)局。方法:回顧分析2014年1月至2016年12月在山東大學(xué)附屬生殖醫(yī)院接受體外受精-胚胎移植(IVF-ET)治療周期的第3天(D3)僅一枚優(yōu)質(zhì)胚胎的3286例患者,其中2677例新鮮周期移植。根據(jù)正常受精數(shù)分為3組:A組僅有一枚正常受精胚胎;B組僅有兩枚正常受精胚胎;C組大于兩枚正常受精胚胎。將3組患者按移植方案再分為3組:第三天移植一枚卵裂期胚胎(D3-1組);第三天移植兩枚卵裂期胚胎(D3-2組);第五天移植一枚囊胚(D5-1組)。分別比較3組患者不同移植方案的臨床結(jié)局。結(jié)果:A組中,D3-1組和D5-1組的臨床妊娠率、胚胎著床率、早期流產(chǎn)率、多胎妊娠率方面均無(wú)顯著差異(P0.05);B組中,D3-2組的臨床妊娠率和多胎妊娠率均高于D3-1組(48.59%vs 33.73%,19.88%vs0,P0.01);C組中,D3-2組的臨床妊娠率和多胎妊娠率均高于D3-1組(52.88%vs 40.24%,34.34%vs 0,P0.01),D3-2組的胚胎著床率低于D5-1組(34.95%vs 46.43%,P0.01),D3-2組的多胎妊娠率高于D5-1組(34.34%vs 1.56%,P0.01);D5有優(yōu)質(zhì)囊胚形成周期占比方面:C組高于A組和B組(68.93%vs 46.70%和56.67%,P0.01);放棄周期率方面:C組低于A組和B組(13.79%vs 32.42%和28.0%,P0.01)。結(jié)論:對(duì)于D3僅一枚優(yōu)質(zhì)胚胎的患者,移植一枚胚胎可顯著降低多胎妊娠率;D5移植降低了胚胎的利用效率;D3移植兩枚卵裂期胚胎比移植一枚卵裂期胚胎可獲得更高的臨床妊娠率;當(dāng)正常受精胚胎數(shù)大于兩枚時(shí),D5移植可以獲得更高的種植率。
[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.
【作者單位】： 山東大學(xué)附屬生殖醫(yī)院;
【基金】：國(guó)家自然科學(xué)基金面上項(xiàng)目(No:81671413) 國(guó)家重點(diǎn)研發(fā)計(jì)劃(No:2016YFC1000604)
【分類號(hào)】：R714.8

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