冻融胚胎卵裂球损伤对移植结局及子代的影响

Effect of blastomere damage of frozen- thawed embryos on transfer outcomes and offsprings

目的分析冻融胚胎卵裂球损伤对移植结局及子代的影响。方法回顾分析1 447例冻融胚胎移植(FET)周期,按移植胚胎卵裂球是否完整分为完整组1 231例(移植胚胎卵裂球均完整)和损伤组216例(移植胚胎中至少1枚有卵裂球损伤),比较两组的一般情况、移植结局及子代情况。结果两组患者的一般情况差异无统计学意义(P>0.05),具有可比性;完整组和损伤组的移植结局相似,临床妊娠率、着床率、多胎妊娠率、异位妊娠率及流产率分别为53.7%、34.9%、29.7%、6.4%、17.1%和54.6%、34.0%、28.8%、5.1%、13.4%,差异无统计学意义(P>0.05);两组新生儿的孕周、出生体重、早产率差异无统计学意义(P>0.05);损伤组低体重儿发生率(21.6%)高于完整组(13.9%),差异有统计学意义(P<0.05);损伤组子代的男女性别比(140∶100)高于完整组子代的男女性别比(107∶100),但差异无统计学意义(P>0.05)。结论卵裂球损伤不会改变移植结局,但对子代会产生一定的影响。

Objective To analyze the effect of blastomere damage of frozen- thawed embryos on transfer outcomes and offsprings.Methods A total of 1 447 frozen-thawed embryo transfer（ FET） cycles were analyzed retrospectively,then they were divided into intact group（ including 1 231 cases with intact blastomeres） and damage group（ including 216 cases with at least one damaged blastomere among all the embryos） according to the integrity of blastomere,the general situations,clinical outcomes and offsprings＇ situations in the two groups were compared. Results There was no statistically significant difference in the general situations between the two groups（ P〉0. 05）. The clinical outcomes in the two groups were similar,the clinical pregnancy rates,implantation rates,multiple pregnancy rates,ectopic pregnancy rates and abortion rates in intact group and damage group were 53. 7%,34. 9%,29. 7%,6. 4%,17. 1% and 54. 6%,34. 0%,28. 8%,5. 1%,13. 4%,respectively,there was no statistically significant difference between the two groups（ P〉0. 05）. There was no statistically significant difference in gestational week,birth weight and premature birth rate between the two groups（ P〉 0. 05）. The incidence rate of low birth weight infants in damage group was 21. 6%,which was statistically significantly higher than that in intact group（ 13. 9%）（ P〈0. 05）. The male-female birth ratio in damage group was 140 ∶ 100,which was higher than that in intact group（ 107 ∶ 100）,but there was no statistically significant difference（ P 〉 0. 05）. Conclusion The damage of blastomeres will not change the outcomes of embryo transfer,but it will affect the offsprings to a certain extent.