【摘要】：目的研究體外受精-胚胎移植(IVF-ET)中,來(lái)自同一促排卵周期的卵子所形成胚胎的臨床結(jié)局,分析鮮胚移植和再次行凍胚移植臨床結(jié)局的相關(guān)性,探討同一簇來(lái)源卵子的發(fā)育潛能。方法以2012年1月-2015年3月期間,在寧夏醫(yī)科大學(xué)總院生殖醫(yī)學(xué)中心實(shí)施IVF/ICSI鮮胚移植及其隨后又行凍融胚胎移植的所有患者為研究對(duì)象。納入標(biāo)準(zhǔn):1.排卵功能正常(超聲監(jiān)測(cè)合并黃體期孕酮水平檢測(cè)證實(shí));2.不孕病因?yàn)檩斅压芤蛩�、男方因�?3.卵巢儲(chǔ)備功能正常CD3:FSH15IU/ml。排除贈(zèng)卵周期和來(lái)源于不同周期胚胎的患者。所有的患者均采用長(zhǎng)方案促排卵,降調(diào)滿(mǎn)意后給予重組卵泡刺激素(rFSH)150-450IU/d啟動(dòng),至卵泡直徑至少2個(gè)≥18mm,肌注人絨毛膜促性腺激素(hCG),36h后取卵。根據(jù)鮮胚移植后妊娠結(jié)局分為兩組,A組是鮮胚移植后妊娠,因流產(chǎn)或計(jì)劃二胎等原因繼而又行凍融胚胎移植,B組是鮮胚移植后未妊娠再次行凍融胚胎移植,比較A組和B組凍融胚胎移植周期(FET)的臨床妊娠率和活產(chǎn)率。結(jié)果鮮胚妊娠組患者冷凍胚胎數(shù)(P=0.016)、優(yōu)質(zhì)胚胎數(shù)(P=0.001)、優(yōu)質(zhì)胚胎率(P=0.01)均高于鮮胚未妊娠組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。在凍融胚胎周期中,A組臨床妊娠率62.5%顯著高于B組臨床妊娠率44.0%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。A組患者活產(chǎn)率55.36%高于B組活產(chǎn)率38.67%,但是P=0.111,差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論同一促排周期獲得的卵子形成的胚胎,鮮胚移植成功妊娠的患者在凍胚周期有著更高的臨床妊娠率,提示同一簇來(lái)源的卵子有著相似的發(fā)育潛能,即鮮胚移植周期成功妊娠對(duì)其隨后凍胚移植結(jié)局有積極的預(yù)測(cè)價(jià)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.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R714.8
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本文編號(hào)：2206871