冻融胚胎移植周期中不同发育阶段胚胎妊娠结局比较

The comparison of clinical outcomes of frozen-thawed embryos transfer at different developmental stages

目的探讨冻融胚胎移植周期中不同发育天数胚胎的发育潜能,为进一步提高FET妊娠率提供依据。方法627例患者830个复苏周期胚胎,根据冷冻时间不同,分为D3冷冻组（n=385）,D5冷冻组（n=300）和D6冷冻组（n=145）,待患者内膜达到8~12 mm时,复苏18~20 h（D3胚胎）或2~3 h（D5/D6）后移植。结果移植胚胎数,D3组显著高于D5和D6组（P〈0.05）,D5冷冻组的临床妊娠率和着床率均显著高于D6冷冻组（61.67%vs 51.03%,46.37%vs 37.94%,P〈0.01）和D3冷冻组（61.67%vs 40.26%,46.37%vs 24.57%,P〈0.01）,多胎妊娠率,D5〉D6〉D3组（P〈0.01）。结论在患者有较多胚胎的情况下,进行囊胚培养冷冻,选择囊胚进行冷冻周期移植能够取得更好的临床结局。

Objective To compare the clinical outcomes of frozen-thawed embryos transfer at different developmental stages in order to provide the basis for further improvement of FET pregnancy rate.Methods A total of 830 frozen-thawed embryos from 627 patients were divided into D3 frozen group（ n = 385）,D5 frozen group（ n = 300） and D6 frozen group（ n = 145） according to frozen days.The frozen-thawed embryos were transferred when the endometrial thickness was around 8 ~ 12 mm and embryos incubation time over 18 ~ 20 h（ D3 group） or 2 ~ 3 h（ D5 / D6 groups） after thawing.Results The number of transplanted embryos in the D3 group was significantly higher than that in the D5 and D6 groups（ P〈 0. 05）.The clinical pregnancy rates and implantation rate of the D5 group were significantly higher than that of the D6 group（ 61. 67% vs.51. 03% for clinic pregnancy rate; 46. 37% vs.37. 94% for implantation rate,P 〈0. 01） and the D3 group（ 61. 67% vs.40. 26% for clinic pregnancy rate; 46. 37% vs. 24. 57% for implantation rate,P〈 0. 01）.Multiple pregnancy rate in the D5 group was higher than that in the D6 groups which was higher than that in the D3 group（ P 〈0. 01）.Conclusion If the patients with more embryos,freezing embryos at blastocyst stage can achieve better clinical outcomes.