两种助孕方式下D5、D6囊胚行冻融移植后妊娠结局的比较

Comparison of pregnancy outcome after D5 and D6 blastocysts under freeze-thawing in two kinds of ART

目的比较体外受精-胚胎移植(ⅣF-ET)与胚胎植入前遗传学诊断或胚胎植入前遗传学筛查(PGD/PGS)周期中D5、D6囊胚形成情况及妊娠结局,同时探究D5、D6囊胚的发育潜能及两种助孕方式的优劣。方法回顾性分析行ⅣF-ET助孕的138个周期及PGD/PGS筛查助孕的148个周期,按移植胚胎的发育天数分为ⅣF-D5组、ⅣF-D6组、PGD/PGS-D5组和PGD/PGS-D6组,分析比较各组的一般情况、囊胚形成情况及冻融移植后的种植率、临床妊娠率、流产率等。结果ⅣF-D5组与ⅣF-D6组相比、PGD/PGS-D5组与PGD/PGS-D6组相比,D5组囊胚形成率、优质胚胎率、种植率、临床妊娠率均高于D6组(P<0.05);PGD/PGS周期中D5组整倍体囊胚检出率高于D6组(P<0.05);ⅣF-D5组与PGD/PGS-D5组相比、ⅣF-D6组与PGD/PGS-D6组相比,两组间的囊胚形成率、优质胚胎率、种植率及临床妊娠率均差异无统计学意义。结论两种助孕方式下冻融移植D5囊胚比D6囊胚可获得较好的临床妊娠结局;与ⅣF相比,PGD/PGS并未明显改善患者的妊娠结局。

Objective To compare the embryogenesis and the outcome of pregnancy about D5 and D6 blastocyst of in vitro fertilization-embryo transfer（ ⅣF-ET） and preimplantation genetic diagnosis/preimplantation genetic screening（ PGD/PGS） cycles,meanwhile explore the development potential of D5 and D6 blastocysts and the advantages and disadvantages of the two methods. Methods 138 cycles of in vitro fertilization-embryo transfer and 148 cycles of preimplantation genetic diagnosis/preimplantation genetic screening were analysed retrospectively. According to the development of transplanted embryos,the patients were divided into four groups： ⅣF-D5 group,ⅣF-D6 group,PGD/PGS-D5 group and PGD/PGS-D6 group. The general situation of each group,the formation of blastocyst and the implantation rate after freeze-thawing,clinical pregnancy rate,abortion rate were analysed. Results Compared with ⅣF-D6 group,PGD/PGS-D6 group,ⅣF-D5 group and PGD/PGS-D5 group had higher blastocyst formation rate,high quality embryo rate,implantation rate and clinical pregnancy rate（ P〈0. 05）. The detection rate of euploid blastocysts in D5 group was higher than that in D6 group in preimplantation genetic diagnosis/preimplantation genetic screening cycles（ P〈0. 05）,and there was no significant difference in blastocyst formation rate,high quality embryo rate,implantation rate and clinical pregnancy rate in each groups. Conclusion D5 blastocysts are able to obtain better clinical outcomes than D6 blastocysts under two kinds feeding methods. Compared with ⅣF,PGD/PGS don＇t significantly improve the pregnancy outcome.