冻融周期移植不同时间囊胚的新生儿结局比较

Effect of blastocyst formation time on neonatal outcomes in frozen-thawed blastocyst transfer cycles

目的比较D5和D6的冻融囊胚移植后的新生儿结局,进一步为复苏囊胚的选择提供指导。方法回顾性分析2005年1月至2012年12月在北京协和医院辅助生育中心进行复苏囊胚移植并已分娩的515例患者资料。按照冷冻前形成囊胚的时间D5或D6进行分组,比较两组的新生儿出生结局;并根据分娩胎数将患者分为单胎组和双胎组,分别比较单胎组和双胎组的新生儿结局。结果 (1)单胎组:D5组的孕龄、出生体重和出生身长分别为(266.5±14.5)d、(3 387.4±584.8)g和(50.1±2.7)cm,与D6组[分别为(268.5±12.6)d、(3 379.7±540.8)g和(50.1±2.1)cm]相比均无统计学差异(P>0.05);D5组男女性别比略高于D6组(1.21vs.1.08),但无统计学差异(P>0.05)。(2)双胎组:D5组新生儿的孕龄、出生体重和出生身长与D6组相比亦均无统计学差异(P>0.05),但D5组新生儿的出生体重[(2 531.0±505.4)g]略低于D6组[(2 601.8±503.0)g];D5组的低体重新生儿发生率(42.3%)高于D6组(31.4%),但无统计学差异(P>0.05);D5组的男女性别比(1.20)高于D6组(0.92),但无统计学差异(P>0.05)。结论在单胎组或双胎组,D5与D6的囊胚冻融移植后出生的新生儿孕周、出生体重和体长均无统计学差异,但是呈现出D6组新生儿体重偏大的趋势;D5组的男女性别比高于D6组,但由于例数所限,未出现统计学差异,还有待于进一步研究。

Objective： To compare the neonatal outcomes of transplantation of frozen-thawed blastocyst on Day 5or Day 6.Methods： The data of 515 patients with frozen-thawed blastocysts transfer cycles and delivered in our reproductive center from January 2005 to December 2012 were retrospectively analyzed.The patients were grouped by the day of blastocyst formation（Day 5or Day 6）.Furthermore,the patients were divided into the single-and twins-birth groups according to the numbers of fetus.Results：In the single birth group,there were no differences in gestational age[（266.5±14.5）days vs.（268.5±12.6）days],birth weight[（3 387.4±584.8）g vs.（3 379.7±540.8）g]and birth length[（50.1±2.7）cm vs.（50.1±2.1）cm]between Day 5and Day 6blastocyst transfer groups（P〉0.05,respectively）.The ratio between male and female baby in Day 5group was slightly higher than that in Day6 group,but not significant（P〉0.05）.In the twins-birth group,there were also no differences in gestational age,birth weight and birth length between the Day 5and Day 6blastocyst transfer groups（P〈0.05,respectively）.The birth weight in Day 5 group was slightly lower than that in Day 6 group[（2 531.0±505.4）g vs.（2 601.8±503.0）g].The rate of low birth weight was lower（42.3% vs.31.4%）and ratio between male and female baby（1.20 vs.0.92）was higher in Day 5group than those in Day 6group,but not significant（P〈0.05）.Conclusions： No matter single-birth or twins-birth,there were no differences in gestational age,birth weight and birth length between Day 5and Day 6blastocyst transfer group.But the birth weight in Day 6group trend to be heavier,and the sex ratio in the Day 5group was slightly higher than that in Day 6group.However,it does not appear significant difference due to the limited number of cases,which needs further investigation.