D5与D6囊胚冷冻复苏移植后妊娠结局和新生儿情况比较

目的比较 D5和D6囊胚冷冻复苏移植后妊娠结局的差别,初步探讨D5 和D6 冷冻囊胚发育潜能的差异,并且为选择性单囊胚移植提供一定的理论支撑.方法回顾性分析2014年1月1日-2014年12月31日期间,在我院生殖中心进行IVF/ICSI-ET助孕后,进行囊胚玻璃化冷冻复苏后移植的 979例病例.将实验对象分为D5 囊胚冷冻复苏组 563 例和D6囊胚冷冻复苏组416例,分别比较两组妊娠结局和新生儿出生情况的差异.关注的参数包括胚胎着床率、临床妊娠率、早期流产率、晚期流产率、异位妊娠率、多胎率、早产率、低体重儿率、极低体重儿率、胎儿畸形率,以及新生婴儿男女比例、体重、身长、Apgar 评分.结果D5 囊胚冷冻复苏移植后胚胎着床率56.07%和临床妊娠率 70.52%分别明显高于D6囊胚冷冻复苏移植后胚胎着床率46.50%和临床妊娠率60.82%,且差异均具有统计学意义（p〈0.05）;D5 囊胚冷冻复苏移植后的多胎率46.60%明显高于D6 囊胚冷冻复苏移植后的多胎率36.36%,且差异具有统计学意义（p〈0.05）;此外,D5 囊胚组和D6 囊胚组妊娠以后的早期流产率、晚期流产率、异位妊娠率、低体重儿率、极低体重儿率、活胎分娩率、死胎分娩率及胎儿畸形率差异均不具有统计学意义（p〉0.05）;D5 囊胚组冷冻复苏移植后新生婴儿中的男女比例 1.18 略高于D6 囊胚组冷冻复苏移植后新生儿中男女比例1.10,但差异不具有统计学意义（p〉0.05）;两组新生婴儿在体重、身长、Apgar 评分上无明显差异.结论与D6 囊胚冷冻复苏组比较,D5 囊胚冷冻复苏组移植后具有更高的胚胎着床率和临床妊娠率.所以 D5囊胚具有更高的着床潜能和发育潜能,尽量选择D5 囊胚进行冷冻复苏移植能提高新生婴儿的出生率.因此在进行选择性单囊胚移植时,可选择D5 的优质囊胚进行单囊胚冷冻复苏和移植,可以降低多胎率,保证较高的临床妊娠率.但是,D5 和D6 囊胚进行冷冻复苏移植,新生儿情况差别不大.

BPurposeTo compare the differences of pregnancy outcome after D5 and D6 blastocystcry opreservation, preliminary study on the developmental potential of D5 and D6 frozen embryos, and provide some theoretical support for the selection of single blastocyst transfer.MethodsA retrospective analysis was conducted on 979 patients who were transplanted after IVF/ICSI-ET assisted pregnancy at the reproductive center of our hospital during January 1, 2014 -2014, December 31st.The difference will be the object points as D5 blastocyst cryopreservation resuscitation group 563 cases and D6 blastocyst cryopreservation resuscitation group of 416 cases, were compared between the two groups of pregnancy outcome and neonatal birth. Parameters of concern including embryo implantation rate, clinical pregnancy rate, early abortion rate, late abortion rate, ectopic pregnancy rate, the rate of multiple births, rates of preterm birth, low birth weight rate, rate of very low birth weight infants, the rate of fetal malformation, andnewborn babies and theratioofmaltfemale,weight,height,andApgarscore.ResultD5 blastocyst cryopreservation after transplantation, embryo implantation rate and clinical pregnancy rate were 56.07% and 70.52% was significantly higher than that of D6 blastocyst cryopreservation after transplantation, embryo implantation rate and clinical pregnancy rate of 46.50% to 60.82%, and the differences were statistically significant （P 〈 0.05）; fetal D5 blastocyst cryopreservation after transplantation rate of 46.60% was significantly higher than that of fetal D6 blastocyst cryopreservation recovery after transplantation was 36.36%, and the difference was statistically significant （P 〈 0.05）; in addition, D5 group and D6 group of blastocysts blastocyst after the early pregnancy abortion rate, abortion rate, ectopic pregnancy rate, low birth weight, very low birth weight rate, live birth rate, stillbirth and fetal birth rate difference the malformation rate were not statistically significant （P 〉 0.05）; D5 group of blastocyst cryopreservation after transplantation of newborn babies in the female ratio of 1.18 is slightly higher than that of D6 blastocyst cryopreservation group after transplantation in the newborn female ratio of 1.10, but there is no statistical difference Significance （P 〉 0.05）; two groups of newborn babies in weight, length, there was no significant difference in Apgar score.ConclusionAnd D6 blastocyst cryopreservation group and D5 blastocyst cryopreservation resuscitation transplantation group with higher implantation rate and clinical pregnancy rate. So D5 blastocyst has higher implantation potential and potential development, try to choose the D5 blastocyst cryopreservation and transplantation can improve the rate of newborn babies born. Therefore in elective single blastocyst transfer, can choose the D5 quality blastocysts were single blastocyst cryopreservation and transplantation, can reduce the rate of multiple births, ensure higher clinical pregnancy rate. However, d5 and D6 blastocyst of frozen thawed embryos and newborn little difference.