冷冻胚胎解冻后单胚胎移植的可行性探讨

Discussion on feasibility of single embryo transfer after the FET cycle

目的探讨冷冻卵裂期胚胎解冻(FET)后单胚胎移植的可行性。方法选取我院收治的不孕患者249例,按照胚胎移植数量分为单胚胎移植组(60例)、双胚胎移植组(168例)、三胚胎移植组(21例),观察胚胎移植情况及临床妊娠情况;双胚胎移植组按胚胎优劣分为双优质胚胎移植组(103例)、单优质胚胎搭配非优质胚胎移植组(50例)、无优质胚胎移植组(15例),观察胚胎移植情况、临床妊娠情况及多胎发生情况。结果单胚胎移植组、双胚胎移植组、三胚胎移植组胚胎种植成功分别为18个(30%)、97个(28.87%)、13个(20.63%),三组比较P均>0.05;临床妊娠分别为18例(30%)、77例(45.83%)、7例(33.33%),单胚胎移植组与双胚胎移植组比较P<0.05。双优质胚胎移植组、单优质胚胎搭配非优质胚胎移植组、无优质胚胎组胚胎种植成功分别为65个(31.55%)、26个(26%)、6个(20%),两两比较P均>0.05;临床妊娠分别为47例(45.63%)、25例(50%)、5例(33.33%),两两比较P均>0.05;多胎发生分别为18例(38.30%)、1例(4%)、1例(20%),双优质胚胎移植组与单优质胚胎搭配非优质胚胎移植组比较P均<0.01。结论 FET后单胚胎移植可行,选择优质胚胎进行单胚胎移植能够获得满意的胚胎种植和临床妊娠结果。

Objective To explore the posibility of single embryo transfer after the frozen-thawed embryo transfer （FET） cycle. Methods There were 249 cycles of human FET in our hospital. According to the number of embryo trans-fer, the cycles were divided into 3 groups, including single embryo transfer group （60 cycles） , double embryos transfer group （168 cycles） and three embryos transfer group （21 cycles）, the condition of embryos transfer and clinical pregnancy was observed; According to embryo quality, double embryos transfer group was divided into double good quality embryos transfer sub-group （103 cycles）, a good quality embryo with a poor quality embryo transfer sub-group （50 cycles） and two poor quality embryos transfer sub-group （15 cycles ） , the embryos implantation rate, clinical pregnancy rate and multiple pregnancy rate were observed. Results There was no statistics differences on embryo implantation rate（ 30% vs. 28.87% vs. 20.63% , all P 〉 0.05 ）among single, double and three embryos transfer groups; The clinical pregnancy cases were 18 （30%） , 77（45.83% ） , 7（33.33% ） , the rate of single embryo transfer group was lower than that of double embryos transfer group （P 〈0.05）. There were 65（31.55% ）, 26（26% ）, 6（20% ）embryos transfered successfully in the double good quality embryos transfer group, a good quality embryo with a poor quality embryo transfer group and t^vo poor quality embryos transfer group （all P 〉0.05） ; The clinical pregnancy cases were 47（45.63% ）, 25（50% ）, 5（33.33% ）, all P 〉0.05 ; The multiple pregnancy cases were 18（38.30% ）, 1 （4%）, 1 （20%）, the rate of double embryo transfer group with a good quality embryo and a poor quality embryo was lower than that of double good quality embryos transfer group （ all P 〈0. 01 ）. Conclusions It is feasible to make single embryo transfer after FET, and single good quality embryo transfer causes a satisfactory clinical pregnancy rate and embryo implantation rate.