融合期胚胎和囊胚移植的探讨

The Study on Human Compacted Embryo and Blastocyst Transfer

目的:探讨融合期胚胎和囊胚单胚胎移植的可行性。方法:选取苏北人民医院生殖医学中心冷冻胚胎解冻移植231个周期的患者为研究对象,比较卵裂期胚胎移植组、融合期胚胎移植组和囊胚移植组的胚胎种植率、临床妊娠率以及多胎的发生率。结果:融合期胚胎移植组平均移植胚胎数低于卵裂期胚胎移植组,差异有统计学意义([1.35±0.50)个vs(.1.73±0.59)个,t=-4.902,P<0.001],但其胚胎种植率和临床妊娠率高于卵裂期胚胎移植组,差异均有统计学意义(49.58%vs.23.00%,χ2=24.567,P<0.001;53.41%vs.34.15%,χ2=7.805,P=0.005);囊胚移植组胚胎种植率高于卵裂期胚胎移植组,差异有统计学意义(46.88%vs.23.00%,χ2=8.214,P=0.004);3组间多胎发生率差异无统计学意义(χ2=2.231,P=0.328)。结论:进行融合期胚胎或囊胚移植可获得较高的胚胎种植率和周期移植妊娠率,降低多胎率,尤其应用于单胚胎移植有重要意义。

Objective ：To explore the posibility of single human compacted embryo and blastocyst transfer. Methods： There were 231 cycles of human frozen-thawed embryo transfer （FET） in the Center of Reproductive Medicine of Northern Jiangsu People＇s Hospital. The study compared embryos implantation rate, clinical pregnancy rate and multiple pregnancy rate among cleavage-stage embryo group, compacted embryo group and blastocyst group of human frozen-thawed embryo. Results： The number of embryo transfer is significantly lower in the compacted embryo group compared to the cleavage-stage embryo group [（1.35±0.50） vs. （1.73±0.59）,t=-4.902,P〈0.001 ）] ,the embryos implantation rate and clinical pregnancy rate of compacted embryo group are higher than cleavage-stage embryo group （49.58% vs. 23.00% ,χ2=24.567 ,P〈0.001 ;53.41% vs. 34.15% ,χ2=7.805 ,P=0.005 ）. The embryos implantation rate of blastocyst group is higher than cleavage-stage embryo group （46.88% vs. 23.00% χ2=8.214,P=0.004）. There was no statistics difference on the multiple pregnancy rate among the three groups （χ2=2.231,P=0.328）. Conclusions：Compacted embryo or blastocyst transfer causes a satisfactory embryo implantation rate and clinical pregnancy rate per transfer cycle, and minimizes the multiple pregnancy rate at the same time. They are very useful for single embryo transfer.