35周岁以下女性D5单囊胚移植结局的临床分析

doi:10.3969/j.issn.1000-8535.2021.05.010

广州医药 ›› 2021, Vol. 52 ›› Issue (5): 48-51.DOI: 10.3969/j.issn.1000-8535.2021.05.010

35周岁以下女性D5单囊胚移植结局的临床分析

杨丽, 刘俊, 陈志恒, 孙玲, 梁元浩, 王慧, 刘帅, 陈娟, 尹敏娜

广州市妇女儿童医疗中心,生殖医学中心(广州 510623)

收稿日期:2021-03-12 出版日期:2021-09-20 发布日期:2021-11-24
通讯作者: 尹敏娜,E-mail:doctor.yin@163.com
基金资助:
国家自然科学基金(81800110);广州市卫生健康科技项目(20191A011027);中华医学会临床医学科研专项基金(18010210750);广州儿科研究所/广州市妇女儿童医疗中心(017104)

Clinical analysis of pregnant outcomes of single blastocyst transfer of day 5 in the women under 35 years old

YANG Li, LIU Jun, CHEN Zhiheng, SUN Ling, LIANG Yuanhao, WANG Hui, LIU Shuai, CHEN Juan, YIN Minna

Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center,Guangzhou 510623,China

Received:2021-03-12 Online:2021-09-20 Published:2021-11-24

摘要/Abstract

摘要： 目的探讨35周岁以下患者行D5单囊胚移植的可行性。方法回顾性分析2016年1月—2019年7月期间,女方年龄≤35岁,在本中心行新鲜周期全胚冻后第一冻融移植的663个周期,根据胚胎发育天数及囊胚移植数目分为三组:D3双优胚移植组(D3双优组:n=508)、D5单囊胚移植组(D5单囊组:n=47)、D5双囊胚移植组(D5双囊组:n=108),对三组的临床结局进行比较分析。结果 D5双囊组临床妊娠率高于D3双优组及D5单囊组,且差异有统计学意义(P＜0.05),但D5单囊组与D3双优组相比,无统计学差异(P＞0.05);D5单囊胚的多胎率低于D5双囊组及D3双优组,差异均有统计学意义(P＜0.001),D3双优组的多胎率也低于D5双囊组,差异亦有统计学意义(P＜0.05);D5单囊组和D5双囊组的种植率都高于D3双优组,差异都有统计学意义(分别是P＜0.05,P＜0.001),而D5单囊组合D5双囊组之间无统计学差异(P＞0.05);但三组之间的早期流产率及宫外孕率均无统计学差异(P＞0.05)。结论年龄≤35周岁的患者全胚冷冻后第一冻融移植周期选择D5单囊胚进行移植,既能获得良好的临床妊娠率和种植率,又极大降低多胎妊娠率。

关键词: 单囊胚移植, 临床妊娠率, 多胎妊娠率, 种植率

Abstract: Objective To investigate the clinical outcomes of the single blastocyst transfer of day 5 in the women under 35 years old. Methods A retrospective study was conducted to analyze clinical outcomes of women less than 35 years old and experienced embryo transfer in the first frozen-thawed cycles from January 2016 to July 2019 in the Center of Reproductive Medicine of Guangzhou Women and Children's Medical Center. According to the embryo developmental days and transfer blastocyst numbers, all patients were divided into three groups: double high-quality cleavage embryo transfer of day 3 (n=508), single blastocyst transfer of day 5(n=47), double blastocyst transfer of day 5(n=108). The clinical outcomes were compared. Results The clinical pregnancy rate of the double blastocyst transfer of day 5 was higher than the other two groups,and the differences were statistically significant(P＜0.05). However, there was no statistical difference between the single blastocyst transfer of day 5 and the double high-quality cleavage embryo transfer of day 3(P＞0.05). The multiple pregnancy rate of the single blastocyst transfer of day 5 was lower than the other two groups, and the differences were statistically significant (P＜0.001),and that of the double high-quality cleavage embryo transfer of day 3 was even lower than that of the double blastocyst transfer of day 5,and the difference was statistically significant(P＜0.05). The implanting rate of the double high-quality cleavage embryo transfer of day 3 was lower than the other two groups, and the differences were statistically significant (P＜0.05;P＜0.001),but there was no statistical difference between the single blastocyst transfer of day 5 and the double blastocyst transfer of day 5 (P＞0.05). However, the early miscarriage rate and the ectopic pregnancy rate did not exhibit statistical differences (P＞0.05). Conclusion Single blastocyst transfer of day 5 can ensure clinical pregnancy rate and implantation rate while effectively reducing multiple pregnancy in the women undergoing the first frozen-thawed cycles of under 35 years old.

Key words: single blastocyst transfer, clinical pregnancy rate, multiple pregnancy rate, implanting rate

杨丽, 刘俊, 陈志恒, 孙玲, 梁元浩, 王慧, 刘帅, 陈娟, 尹敏娜. 35周岁以下女性D5单囊胚移植结局的临床分析[J]. 广州医药, 2021, 52(5): 48-51.

YANG Li, LIU Jun, CHEN Zhiheng, SUN Ling, LIANG Yuanhao, WANG Hui, LIU Shuai, CHEN Juan, YIN Minna. Clinical analysis of pregnant outcomes of single blastocyst transfer of day 5 in the women under 35 years old[J]. Guangzhou Medical Journal, 2021, 52(5): 48-51.

参考文献

[1] 何雪仪,梁月梅,陈敏霞,等.双胎妊娠的临床结局分析[J].中国妇幼保健,2019,34(24):5630-5631.
[2] 罗桂英,王春艳,魏兆莲,等.医源性多胎妊娠患者的焦虑抑郁现状及影响因素分析[J].中华疾病控制杂志,2018,22(4):374-379.
[3] VEGA M, ZAGHI S, BUYUK E, et al. Not all twins are monozygotic after elective single embryo transfer: analysis of 32,600 elective single embryo transfer cycles as reported to the Society for Assisted Reproductive Technology[J].Fertil Steril, 2018, 109(1):118-122.
[4] 徐琳,孙丽洲,刘娟,等.Logistic回归分析重度子痫前期母婴不良结局的风险因素[J].南京医科大学学报(自然科学版),2018,38(8):1151-1153.
[5] 张庆颜, 陈士岭, 周星宇,等. 全面二孩政策下多胎妊娠减胎术55例临床结局分析[J].实用医学杂志, 2019, 35(14):2243-2245.
[6] 赵君利,袁莹莹.辅助生殖治疗中多胎妊娠的防治[J].山东大学学报(医学版),2019,57(10):20-26.
[7] SUNDERAM S, KISSIN D M, ZHANG Y J, et al. Assisted reproductive technology surveillance-United States,2016[J]. Surveill Summ,2019,68(4):1-23.
[8] 孙贻娟,黄国宁,孙海翔,等.关于胚胎移植数目的中国专家共识[J].生殖医学杂志,2018,27(10):940-945.
[9] GAZDARU S, SURBONE A, MATHEVET P, et al. Assisted reproductive technology: strategies ofelective singleembryo transfer [J].Rev Med Suisse,2017,13 (580):1832-1837.
[10] MANCUSO A, KAPFHAMER J. With a good quality blastocyst, single embryo transfer remains the best choice[J]. Fertil Steril,2018,110(4):655-660.
[11] TANNUS S, SON W Y, DAHAN M H.Elective single blastocyst transfer inadvanced maternal age[J].J Assist Reprod Genet,2017,34(6):741-748.
[12] 洪焱, 黄绘,骆荣,等. 选择性单囊胚移植在辅助生殖技术中的应用研究[J].中国妇幼保健, 2019, 34(5):1101-1103.
[13] 刘景,孔红娇, 胡继君,等.冷冻复苏周期不同囊胚移植方案对不同年龄患者妊娠结局的影响[J].实用医学杂志,2020,36(7):925-929.
[14] 梁明明,唐永梅,韦立红,等.冻融移植周期中单、双囊胚及卵裂期双胚胎移植结局的临床分析[J].中国计划生育学杂志, 20l6, 24(10): 682-686.
[15] 陈攀宇,方丛,贾磊,等.复苏周期D5单囊胚移植与双囊胚移植对妊娠结局的影响[J].生殖医学杂志,2016,25(12):1049-1053.
[16] GARDNER D K, LANE M, STEVENS J, et al. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer[J]. Fertil Steril,2000,73(6):1155-1158.
[17] 刘琦,谢娟珂,韦多,等.冻融周期中优质卵裂期双胚移植与选择性单囊胚移植的早期妊娠结局比较[J].河南医学研究,2018,27(24):4419-4421.
[18] 李宁,杨华,李春苑,等.冻融周期中单囊胚与双囊胚移植的妊娠结局分析[J].中华妇产科杂志,2020,55(11):778-783.
[19] GLUJOVSKY D, FARQUHAR C,QUINTEIRO RETAMAR A M, et al. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology[DB/OL].Cochrane Database Syst Rev,2016(6):CD002118.

35周岁以下女性D5单囊胚移植结局的临床分析

Clinical analysis of pregnant outcomes of single blastocyst transfer of day 5 in the women under 35 years old

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 0

编辑推荐

Metrics

本文评价