移植复苏周期第5日和第6日冻融囊胚发育潜能的比较

Comparison of the developmental potential of day 5 and day 6 frozen-thawed blastocysts during clinical application

目的比较移植复苏周期第5日(D5)、第6日(D6)冻融囊胚对妊娠结局的影响,探讨D5和D6囊胚的发育潜能。方法收集行复苏周期单囊胚移植480个周期及双囊胚移植783个周期的临床资料,按照冻融时胚胎发育的不同阶段分为4组:单囊胚D5移植组(SET-D5组,255个周期),单囊胚D6移植组(SET-D6组,225个周期),双囊胚D5移植组(DET-D5组,475个周期)和双囊胚D6移植组(DET-D6组,308个周期),比较其妊娠结局。结果 SET-D5组比SET-D6组获得了较高的临床妊娠率(58.8%比35.1%,P<0.01)和种植率(60.0%比34.2%,P<0.01)。DETD5组的临床妊娠率(69.5%比51.9%,P<0.01)、种植率(53.4%比34.9%,P<0.01)也明显高于DET-D6组。对于同一发育时间,无论移植1枚还是2枚胚胎,种植率比较差异无统计学意义(P均>0.05)。结论复苏周期移植D5囊胚比D6可以获得更好的妊娠结局,D5胚胎具有更好的发育潜能。

Objective To compare and evaluate the developmental potential of day 5 and day 6 fro-zen-thawed blastocysts during clinical application.Methods 480 cycles of single thawed blastocyst and 783 cycles of double thawed blastocysts transferred were retrospectively analyzed.All the cycles were divided into four groups based different developmental stages： those single embryo transferred of day 5/day 6 were labeled as SET-D5 group （n=255） /SET-D6 group （n=225）, those double embryos transferred of day 5/day 6 were labeled as DET-D5 group （n=475） /DET-D6 group （n=308）.The pregnancy outcomes were compared in the four groups.Results Compared with SET-D6 group, there was higher clinical pregnancy rate （58.8% vs 35.1%, P 〈0.01 ） and implantation rate （ 60.0% vs 34.2%, P 〈0.01 ） in SET-D5 group.And there wasalso greater clinical pregnancy rate （ 69.5% vs 51.9%, P 〈0.01 ） and implantation rate （ 53.4% vs 34.9%, P〈0.01） in DET-D5 group than that in DET-D6 group.However, there was no the statistical signif-icance of implantation rate between the groups with the same developmental stage embryos （P〉0.05）.Con-clusion The pregnancy outcomes and developmental potential in frozen embryo transfer of D 5 were better than D6.