冻融周期第5天、第6天和第7天囊胚移植结局分析

Comparison of the Pregnancy Outcomes Among Day 5,Day 6,and Day 7 Frozen-Thawed Blastocysts Transfers

目的:分析比较冻融移植第5天(D5)、第6天(D6)和第7天(D7)的囊胚对妊娠结局的影响,初步探讨D5、D6、D7冻融囊胚的发育潜能。方法:回顾性分析2012年7月1日-2013年12月31日在我院生殖中心采用标准长方案IVF/ICSI-ET助孕后,行囊胚冻融移植患者。按移植的囊胚形成天数以及移植囊胚数分为6组。单D5组:单D5囊胚移植,70周期;单D6组:单D6囊胚移植,90周期;单D7组:单D7囊胚移植,30个周期;双D5组:双D5囊胚移植,559周期;双D6组:双D6囊胚移植,345周期;双D7组:双D7囊胚移植,59周期;分析比较各组之间的妊娠结局。结果:D5、D6、D7冻融囊胚复苏率依次降低(97.24%,93.11%,84.42%,P均<0.001)。单囊胚D5临床妊娠率及胚胎着床率均高于单囊胚D6(55.71%vs 32.22%,57.14%vs 32.22%,P均<0.05),但单囊胚D6与单囊胚D7两者差异无统计学意义。双囊胚冻融移植D5、D6、D7临床妊娠率依次降低(74.24%,62.61%,5.59%,P均<0.001),胚胎着床率依次减少(56.71%,41.30%,22.88%,P均<0.001)。双囊胚D5多胎率高于双囊胚D6(47.95%,29.63%,P<0.001),两者流产率无显著性差异。双囊胚D6流产率低于双囊胚D7(9.72%,23.81%,P<0.05),两者多胎率无显著性差异。结论:冻融囊胚移植D5比D6、D6比D7可以获得更好的临床妊娠结局,D5、D6、D7囊胚发育潜能依次降低。冻融移植D7囊胚依然可以获得一定的临床妊娠率。

Objective：To compare and analyze the pregnancy outcomes of Day 5,Day 6,and Day 7frozen-thawed blastocysts transfers,and to evaluate the developmental potential of the blastocysts formed in different time.Methods：It＇s a retrospective study.All of the patients that enrolled in the study used standard long protocol in our IVF center from July 1,2012 to December 31,2013.They were divided into six groups according to the day of blastocyst development and the number of embryo transferr：those single blastocyst transferred on Day 5,Day 6,and Day 7were labeled as SD5group（n=70）,SD6group（n=90）,and SD7group（n=30）respectively;those double blastocyst transferred on Day 5,Day 6,and Day 7were labeled as DD5group（n=559）,DD6group（n=345）,and DD7group（n=59）respectively.The pregnancy outcomes were compared among the six groups.Results：The post-thaw survival rate of blastosysts frozen by Day 5,Day6,and Day 7was decreased（97.24%,93.11%,and 84.42%,P〈0.001）.The clinical pregnan-cy and implantation rate for single blastocyst transferred of Day 5was higher than the rate of Day6（55.71%vs 32.22%,57.14%vs 32.22%,P〈0.05）,but no significant difference was found between Day 6and Day 7.The rates of clinical pregnancy and implantation for double blastocysts transferred from Day 5to Day 7were decreasing（74.24%,62.61%,and 35.59%,all P〈0.001;56.71%,41.30%,and 22.88%,all P〈0.001）.And the multiple pregnancy rate of Day5 was higher than that of Day 6（47.95%vs 29.63%,P〈0.001）,but no significant difference was found in abortion rate.At the same time,the abortion rate of Day 6was lower than the that of Day 7（9.72%vs 23.81%,P〈0.05）,but no significant difference was found in multiple pregnancy rate.Conclusion：The pregnancy outcomes and the developmental potential in frozen blastocycst transfer of Day 5,Day 6,and Day 7were better by steps.But Day 7frozen-thawed blastocysts transferr can also get a certain of pregnancy outcomes.