冻融周期非优质单囊胚移植妊娠结局的比较

The Pregnant Outcome of Poor-quality Single-blastocyst Transfer in Vitrified-warmed Cycles

目的:比较D5和D6非优质单囊胚玻璃化冷冻复苏移植后的临床结局,优化非优质单囊胚的移植策略。方法:回顾性分析2013年1月-2016年12月在福建省妇幼保健院生殖中心施行冻融周期非优质单囊胚移植患者的临床资料230例,依据囊胚质量和囊胚发育的天数将非优质单囊胚移植的患者分为4组,分别是D5的AC/BC组(内细胞团、滋养层评分为AC或BC,53个周期)、CA/CB组(51个周期)、D6的AC/BC组(65个周期),CA/CB组(61个周期),比较各组的临床妊娠率和早期流产率。结果:D5组非优质囊胚临床妊娠率高于D6组,且CA/CB(D5)组的临床妊娠率高于AC/BC(D6)组,差异有统计学意义(P<0.05)。AC/BC组的早期流产率高于CA/CB组,差异有统计学意义(P<0.05)。结论:在非优质单囊胚移植周期中,优先考虑滋养外胚层评分高的D5囊胚,可提高妊娠率,降低早期流产率。

Objective：To compare the clinical outcomes of single poor-quality blastocysts between D5 and D6 vitrified-warmed blastocyst transfer cycles, and to optimize the single transfer strategy of poor-quality blastocyst. Methods：A retrospective analysis of the clinical data from patients underwent vitrified-warmed poor-quality single-blastocyst transfer cycles in our center from January 2013 to December 2016. According to the quality of blastocyst and the day of blastocyst development, those patients underwent ET were divided into 4 groups as follows, the D5 including AC/BC group （Inner cell mass and trophoblast score were AC or BC, 53 cycles in total）, the D5 including CA/CB group （51 cycles） and the D6 including AC/BC group （65 cycles）, the D6 including CA/CB group （61 cycles）. The clinical pregnancy rate and early abortion rate were compared. Results：The clinical pregnancy rate of D5 group was higher than that of D6 group （P〈0.05）, and the clinical pregnancy rate of CA/CB （D5） group was statistically significantly higher than that of AC/BC （D6） group （P〈0.05）. The early abortion rate of AC/BC group was statistically significantly higher than CA/CB group （P〈0.05）. Conclusions：The D5 blastocysts with high trophoblastic ectoderm grade can be selected for transfer so as to improve the pregnancy rate and reduce the early abortion rate.