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。

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.

目的 探讨孕中后期中低等强度有氧运动对高龄孕妇产前生活质量和母婴结局的影响。方法 选2017年8月—2018年12月我院接收的560名高龄孕妇作为研究对象,随机分成数量相等的两组。对照组采取常规孕期保健服务和健康教育,观察组则在此基础上增加孕中后期中低等有氧运动的干预,问卷法调查两组孕妇的抑郁情况、睡眠质量、产前生活质量,并比较两组孕妇的母婴结局。结果 χ²检验结果显示,研究组对象平均每周运动次数≥3次及平均每次运动时间≥30 min的比例高于对照组(P=0.001)。研究组对象的EPDS抑郁分值和SRSS睡眠质量分值均低于对照(P=0.006)。研究组对象产前GQOLI-74生活质量问卷中生活质量总得分高于对照组(P=0.000 1)。研究组对象的妊娠糖尿病、妊娠高血压、难产率、巨大儿发生率均低于对照组(P=0.039),但自然分娩率高于对照组(P=0.004)。结论 以瑜伽、慢走或散步为主的中低强度的有氧运动可能有助于提供高龄孕妇的产前生活质量,预防妊娠疾病和不良母婴结局,在临床上具有一定的推广意义。

Objective To study the influences of medium or low strength aerobics during 2^nd and 3^rd trimester on life quality and pregnant outcome of elderly pregnant women. Methods To select 560 elderly pregnant women in our hospital during August 2017 to December 2018 as the objects of this study. Objects were divided into control group which was given routine pregnant health services and study group which was given medium or low strength aerobicsduring 2^nd and 3^rd trimester excluding in addition. Questionnaires were used for collecting messages of depression, sleeping, life quality of objects. Pregnant outcome were compared of two groups by Chi-square test in this study. Results The ratio of average aerobics more than 3 times per week and average time more than 30min each time of study group were higher than control group(P=0.001). The scores of EPDS and SRSS of study group were lower than control group(P=0.006). The scores of GQOLI-74 of study group were higher than control group(P=0.000 1). The ratio of pregnant diabetes mellitus, pregnant hypertension, dystocia, fetal macrosomia of study group were lower than control group(P=0.039) but the ratio of eutocia was higher than control group(P=0.004). Conclusion The medium or low strength aerobics such as Yoga, taking a walk may improve pregnant life quality of elderly pregnant women and prevent pregnancy disease and abnormal pregnant outcome that deserved to promote in clinic.