不同移植液对胚胎移植临床结局的影响

Effect of different transfer medium on clinical outcome of embryo transfer.

目的:比较不同移植天数,G-1、G-2、EmbryoGlue作为移植液对胚胎移植临床结局的影响。方法:回顾分析2011年11月至2012年3月在山东大学附属生殖医院接受体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)或卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)治疗周期的1517例患者,按移植天数不同,分为第2天(D2)移植组、第3天(D3)移植组、第5天(D5)移植组。分别比较G-1、EmbryoGlue对D2移植的临床结局的影响,G-2、EmbryoGlue对D3和D5移植的临床结局的影响。结果:D2移植组中G-1和EmbryoGlue作为移植液的临床妊娠率、胚胎着床率、胚胎停育率、胚胎流产率、胚胎异位妊娠率、胚胎活产率、婴儿早产率、婴儿足月产率均无显著差异(P>0.05)。D3移植组中,G-2与EmbryoGlue作为移植液的临床妊娠率、胚胎着床率、胚胎停育率、胚胎异位妊娠率、婴儿早产率、婴儿足月产率均无显著差异(P>0.05);但G-2作为移植液的胚胎流产率显著低于EmbryoGlue[4.99%(21/441)vs 9.90%(40/404),P<0.01],胚胎活产率显著高于EmbryoGlue[81.41%(359/441)vs 74.50%(301/404),P<0.05]。D5移植组中,G-2与EmbryoGlue作为移植液的妊娠结局均无显著差异(P>0.05)。结论:用G-1、G-2作为胚胎移植液同样可获得较好的临床结局;与EmbryoGlue相比,G-2作为D3胚胎移植液在胚胎流产率和胚胎活产率指标方面具有优势。

Objective：To compare the results of different transfer medium on clinical outcomes after embryo transfer. Methods： 1517 infertile patients underwent IVF or ICSI in our IVF center from Nov. 2011 to March 2012. The patients were divided into three groups accord-ing to their transfer day：day two （D2） transfer group,day three （D3） transfer group, day five （D5） transfer group. Clinical outcomes were compared between corresponding sequential cul-ture medium and EmbryoGlue in the three groups. Result：In D2 transfer group,there were no significant difference in clinical outcomes （clinical pregnancy rate, implantation rate, embryo damage rate, abortion rate, ectopic pregnancy rate, live births rate, preterm birth rate and term birth rate） （P〉0.05）. In D3 transfer group, abortion rate was significantly lower in the sub- group using G-214.99% （21/441） vs 9.90% （40/404） ,P〈0.01 ], and the live births rate was also impaired if EmbryoGlue had been used[74.50% （301/404） vs 81.41% （359/441）, P〈0.05], In D5 transfer group, there were no significant difference in clinical outcomes（P〉 0. 05）. Conclusion： Satisfying clinical outcome can be obtained by solely using G-1 or G-2 as embryo transfer medium. When adopted as D3 transfer media, abortion rate and clinical preg-nancy rate can be ameliorated than using EmbryoGlue as transfer media.