卵巢过度刺激综合征高风险患者单囊胚移植的应用

Clinical application of single-blastocyst transfer in high-risk patients for ovarian hyperstimulation syndrome

目的:探讨在卵巢过度刺激综合征(OHSS)高风险患者中移植单囊胚的妊娠结局。方法:回顾分析2009年8月至2011年8月在我中心助孕的患者,OHSS高风险患者中移植单囊胚者为囊胚组(136例)、移植D3天新鲜胚胎者为胚胎组(142例)、全部胚胎冷冻后择期行冻融胚胎移植者为冷冻组(155例),分析组间临床特征、超促排卵情况、胚胎质量、妊娠率、着床率、多胎率、中重度OHSS发生率。结果:3组间的临床特征、超排卵情况、胚胎形成情况均无统计学差异(P>0.05)。3组间着床率、临床妊娠率、多胎妊娠率、中重度OHSS发生率均有统计学差异(P<0.05)。单囊胚移植组的着床率(51.47%)高于其他两组,临床妊娠率(51.47%)高于冻融胚胎组,多胎率(1.43%)明显低于其他两组,中重度OHSS发生率(0.74%)低于胚胎移植组,与冻融胚胎组无明显差异。结论:单囊胚移植在保证较高妊娠率的同时显著降低了多胎妊娠率,但并未增高OHSS发生率。

Objective：To investigate the pregnancy outcomes of single-blastocyst transfer（SBT）in the patients who have high-risk for OHSS.Methods：The clinical data of the patients who received assisted reproductive technology in our center during August 2009 to August 2011 were analyzed retrospectively.The high-risk patients for OHSS who received SBT were for trial group,who received cleavage-stage embryo transfer and freezing embryo transfer for two control groups.The clinical features,controlled ovarian hyperstimulation（COH）,pregnancy rate,implantation rate,multiple pregnancy rate,incidence of moderate to severe OHSS were included.Results：The clinical characteristics,COH,embryo formation among the three groups had no statistical difference（P0.05）.Implantation rate,clinical pregnancy rate,multiple pregnancy rate,the rate of occurrence of severe OHSS among the three groups were significantly different（P0.05）.Implantation rate of SBT（51.47%）was higher than the other two groups,and the clinical pregnancy rate（51.47%） was more than frozen-thawed embryo group.Multiple pregnancy rate of SBT group（1.43%） was significantly lower than the other two groups,and the occurrence of severe OHSS rate（0.74%） was lower than the embryo transfer group,with no significant difference compared with the freezing embryo transfer group.Conclusion：Single-blastocyst transfer can ensure a higher pregnancy rate,while significantly reduce the multiple pregnancy rates,but not increase the incidence of OHSS.