复苏周期中单囊胚评分与助孕结局的关系

Relationship between balstocyst scoring and pregnancy outcome in single frozen-thawed blastocyst transfer cycles

目的从胚胎学角度探讨囊胚内细胞团、滋养层细胞与助孕结局的关系,为开展选择性单囊胚移植提供理论依据。方法回顾性分析福建省妇幼保健院生殖中心共391个单囊胚解冻周期,比较囊胚滋养层细胞分级、内细胞分级与妊娠率、流产率的关系。结果优质囊胚妊娠率为52.46%,非优质囊胚妊娠率为37.31%,两者比较,差异具有统计学意义(P<0.05),流产率无统计学意义;内细胞团评分A级的妊娠率显著高于评分B级、C级(P<0.01),流产率无统计学差异;滋养层评分A级的妊娠率与B、C级的妊娠率比较,差异有统计学意义(P<0.01),但是滋养层细胞C级的占流产总人数的13.04%,内细胞评分C级的无流产发生。结论优质囊胚移植可以获得高的妊娠率;囊胚内细胞团质量和滋养细胞质量与妊娠结局有关,滋养层细胞的质量可能与早期流产有关。

Objective To explore the relationship between inner cell mass of blastocyst,trophoblast cells,and pregnancy outcome from the point of embryology,provide a theoretical basis for selective single blastocyst transfer. Methods A total of 391 single frozen-thawed blastocyst transfer cycles in Reproductive Center of the hospital were analyzed retrospectively,the relationships between trophoblast cells grading,inner cells grading and pregancy rate,abortion rate were analyzed. Results The pregancy rates of high-quality single blastocyst and non-high-quality blastocyst were 52. 46% and 37. 31%,respectively,there was significent difference（ P〈0. 05）,but there was no significent difference in abortion rate. The pregancy rate of grade A inner cells was significently higher than those of grade B and C inner cells（ P〈0. 01）. There was significent difference in pregnancy rate between grade A trophoblast cells and grade B and C trophoblast cells（ P〈0. 01）,the proportion of abortion cases with grade trophoblast cells was 13. 04%,no abortion occurred among the cases with grade C inner cells. Conclusion High-quality blastocyst can get higher pregnancy rate,the quality of trophoblastic cells and inner cell mass is associated with pregnancy outcome,the quality of trophoblastic cells may be correlated with early abortion.