非选择性单胚胎移植的胚胎着床能力及临床结局分析

Analysis of Embryo Implantation Capacity and Clinical Pregnancy Outcomes after Non-elective Single Embryo Transfer

目的：探讨非选择性单胚胎移植（SET）的临床妊娠结局及单胚胎移植的可行性。方法：回顾2002年1月至2007年8月在南方医院生殖医学中心进行体外受精-胚胎移植（IVF-ET）治疗的病例，选择仅有单个胚胎可供移植的202个新鲜周期，分析SET的临床妊娠结局与年龄、卵巢反应性及胚胎卵裂球数的关系。结果：非选择性单胚胎移植的临床妊娠率为19．8％；〈30岁组、30～35岁组、36～40岁组、〉4JD岁组临床妊娠率比较，差异无显著性（P=0．192）；卵巢正常反应组、低反应组的临床妊娠率比较，差异无显著性（P=0．673）；7～8细胞胚胎组、6细胞胚胎组、4～5细胞胚胎组、2～3细胞胚胎组的临床妊娠率比较，差异有非常显著性（P=0．002）。结论：非选择性单胚胎移植的着床能力和临床妊娠率与胚胎质量的关系最为密切，以7～8细胞胚胎的着床率和临床妊娠率最高。对于年龄在35岁以下，卵巢反应正常者，选择优质胚胎进行SET能够得到良好的妊娠结局。

Objective：To analyze the clinical pregnancy outcomes of non-elective single embryo transfer and discuss the feasibility of elective single embryo transfer （SET）. Methods： A retrospective analysis was carded out on in vitro fertilization-embryo transfer （IVF-ET） cycles of Center for Reproductive Medicine in Nanfang Hospital between January 1, 2002 and August 31, 2007. Only one embryo was available to transfer in 202 cycles, to analyze the relations of age, ovarian response, number of embryo blastomere, and clinical pregnancy fate. Results： The average clinical pregnancy rate was 19.8% in the 202 SET cycles. The pregnancy rates were 30.8%, 19.4%, 16.3%, and 9.5% in 〈 30 yr,30 - 35 yr,36 - 40 yr, and 〉 40 yr group, respectively, and there was no statistically significant difference（ P= 0. 192）. The pregnancy rates were 20.0% and 17.6% in normal response and low response with no statistically significant difference （P=0.673）. The pregnancy rates were 7.7%, 12.7%, 15.6%, and 34.9% in the 2- 3 cell embryo group, 4 - 5 cell embryo group, 6 cell embryo group, and 7 - 8 cell embryo group, respectively, and there was statistically significant difference among them（ P = 0.002）. Conclusions： The clinical pregnancy rate closely related to the quality of embryo in the SET cycles, and the highest in the 7 - 8 cell embryo groups. For the ovarian normal response, elective SET can be applied to women under 35 years, and have satisfactory outcomes.