IVF-ET卵巢高反应患者行囊胚移植的临床结局分析

Clinical outcome of blastocyst transfer of patients with ovarian hyperresponsiveness in IVF-ET

目的探讨体外受精-胚胎移植卵巢高反应患者行囊胚移植的妊娠结局和应用价值。方法回顾性分析2016年5月至2017年2月在我院生殖中心进行体外受精-胚胎移植(IVF-ET)治疗的不孕患者资料,卵巢过度刺激综合征(OHSS)高风险患者行双卵裂胚移植84个周期(A组),行普通单囊胚移植58个周期(非优质囊胚),行单优质囊胚移植40个周期,比较三组患者常规临床特征、超促排卵情况、胚胎发育质量、临床妊娠率、种植率、多胎率、中重OHSS发生率。结果三组不孕患者体重指数、基础FSH、Gn使用量、Gn使用时间、HCG注射日E2/P水平、获卵数、受精率、卵裂率等相互比较均无统计学意义(P>0.05)。单优质囊胚组的妊娠率显著高于双卵裂胚移植组和单囊胚移植组(P<0.05)。双卵裂胚移植组的种植率显著低于单囊胚移植组和单优质囊胚组(P<0.05),同时双卵裂胚移植组的多胎率显著高于其他两组(P<0.01)。双卵裂胚移植组的中重度OHSS发生率为10.67%,高于其他两组,差异具有统计学意义(P<0.05)。结论卵巢过度刺激综合征高风险患者行单囊胚移植可以减小0HSS及多胎妊娠的发生,且不影响临床妊娠率。

Objective：To investigate the clinical application value of blastocyst transfer of patients with ovarian hyperresponsiveness in IVF-ET.Methods：Data of patients who received assisted reproductive technology in our center from May 2016 to February 2017 were retrospectively analyzed.Patients with high risks for OHSS were divided into 3 groups：Group A received 84 cycles of double embryo transfer,Group B received 58 cycles of single non-quality blastocyst transfer,and Group C received 40 cycles of single high quality blastocyst transfer.The clinical general condition,controlled ovarian hyperstimulation,embryo development information,pregnancy rate,implantation rate,multiple pregnancy rate,incidence of moderate to severe OHSS were recorded and analyzed.Results：The clinical characteristics,COH,embryo information among the three groups had no statistical diference（P〈0.05）. Clinical pregnancy rate of single high quality blastocyst transfer was obviously higher than those in double embryo transfer group and single non-quality blastocyst transfer group,while implantation rate of double embryo transfer group was lower than those in the other two groups（P〈0.05）. In addition,multiple pregnancy rate of double embryo transfer group was significantly higher than the other two groups（P〈0.01）. And the incidence of moderate to severe OHSS in the double embryo transfer group was 10.67%,which was higher than that in the other two groups（P〈0.05）. Conclusions：Single embryo transfer would not reduce pregnancy rate,while could significantly reduce the incidence of OHSS and the multiple pregnancy rates.