低回收卵患者囊胚培养和移植结局的初步探讨

Preliminary study on application of blastocyst culture and day 5 transfer in patients with low oocyte number

目的 探讨体外受精 胚胎移植 (IVF ET)中 ,在低回收卵数患者中进行囊胚培养和移植是否能改善IVF结局。方法 回顾分析 2 0 0 0年 1月至 2月在我室行IVF治疗的 5 9例患者的临床资料。其中 2 1例行囊胚培养 (囊胚组 ) ,在受精后第 5天移植 ;另 3 8例行常规的第 2天胚胎移植 (对照组 )。比较分析两组患者的临床结局。结果 囊胚组平均取卵数 ( 6 6± 2 8)个 ,临床妊娠率为 4 3 % ,分娩率 3 8% ;对照组平均取卵数 ( 6 9± 3 7)个 ,临床妊娠率为 3 7% ,分娩率 2 9% ,两组比较 ,差异无显著性 (P >0 0 5 )。囊胚组无一例出现高序多胎 ,对照组出现 1例 3胎 ,1例 5胎。结论 在IVF ET中 ,对低回收卵数患者进行囊胚培养和移植与常规第 2天移植相比 ,并不会显著提高妊娠率 ,但却可以在不降低妊娠率的情况下 ,减少多胎的出现。

Objective To evaluate whether blastocyst culture and transfer in patients with low oocyte number can effectively improve the outcome of in vitro fertilization embryo transfer treatment Methods Retrospectively analyze 59 couples received conventional in vitro fertilization and embryo transfer (IVF ET) treatment in our center from January to February 2000 Twenty one couples had blastocyst culture and day 5 embryo transfer and another 38 couples had day 2 embryo transfer as the control Their clinical and laboratory results were compared between these two groups Results In day 5 group the mean oocytes retrieved were (6 6± 2 8), the clinical pregnancy rates (PRs) was 43% and the life delivery rate was 38%; while in day 2 group the results were (6 9±3 7),37% and 29% respectively There was no significant difference between two groups No high order multiple birth occurred in day 5 group, but in day 2 group there were two cases: one with triplets and another with pentadriplet who had the embryos reduction Conclusions These results demonstrate that nonselective blastocyst culture and transfer in patients with low oocyte number seems not effectively to improve the PRs and the delivery rate, but may decrease the occurrence of mutiple birth without affecting the final pregnancy results when compared with conventional day 2 transfer