单个液滴内胚胎培养数量及同培养非移植胚胎质量对妊娠结局的影响

Effect of the Quality of Co-Cultured Non-Transfer Embryo and Em- bryo Number in A Single Droplet on Pregnancy Outcome

目的分析单个液滴内同培养非移植胚胎质量对妊娠结局的影响，探讨同培养方式及同培养非移植胚胎对移植胚胎植入潜能的影响。方法回顾性分析1587例行体外受精．胚胎移植（IVF-ET）患者的资料，根据移植胚胎来源微滴的不同将患者分组，A组为移植胚胎来源于同一培养微滴，c组移植的胚胎来源于完全单独培养的两个不同微滴，B组移植的胚胎中至少1枚来源于双胚胎同培养的微滴（即1个微滴中培养两枚胚胎），根据D3共培养的胚胎质量将B组分为B1和B2两个亚组（共培养的均为优质胚胎为B1组，反之为B2组），分析各组患者的临床妊娠结局。结果各组问的基础资料没有显著差异。与其他组相比．A组移植的胚胎数最低．且B1组移植胚胎数也显著高于B2组、c组。A组的种植率显著高于B组及B2组．B1组及c组种植率也显著高于B2组（P〈0．05）。A组、c组及B1组临床妊娠率均显著高于B2组（P〈0．05）。当移植胚胎数为2枚时，A组的种植率显著高于B组，且A组、C组及B1组的种植率及临床妊娠率均显著高于B2组（P〈0．05）。当移植胚胎数为3时，c组种植率显著高于B2组（P〈0．05）。结论移植来源于同一微滴、且共培养胚胎D3为优质胚胎的患者有较高的种植率及妊娠率，移植共培养胚胎为非优质胚胎可能对患者的临床结局有不利影响。

Objective To examine the effect of the quality of co-cultured non-transfer embryo in a single droplet on pregnancy outcome, and explore the effect of culture method and co-cultured non-transfer embryos on implantation potential. Methods Clinical data of 1587 IVF-ET patients were retrospectively analyzed. Patients were divided into different groups according to the droplets from which the embryo came. In group A, the transferred embryos were from a single droplet. In group B, at least one embryo was from co-culture system. In group C, the embryo was from two dif- ferent droplets. Group B was divided into two subgroups, group B1 （top quality embryo） and group B2 （non-top quality embryo）, according to the co-cultured embryo quality. The clinical pregnancy outcomes were compared between these groups. Results There was no significant difference in basic data between these groups. The number of transferred embryo was lower in group A than in other groups, and that was higher in group B1 than in group C and group B2. The implantation rate was higher in group A than in group B and group B2, and greater in group B1 and group C than in group B2 （P 〈0. 05） . The clinical pregnancy rate in group A, group B1 and group C was higher than in group B2. When two embryos were transferred, the implantation rate was significantly en-hanced in group A relative to group B, and the clinical pregnancy rate was higher in group A, group B1 and group C than in group B2. When three embryos were transferred, the implantation rate was significantly increased in group C when compared with group B2 （ P 〈 0. 05 ） . Conclusion Patients who were transferred with co-cultured top quality embryo from the same single droplet have better implantation rate and clinical pregnancy rate, and transfer of co-cultured non-top quality em- bryo may have an adverse effect on clinical outcomes.