冻融囊胚移植结局的影响因素分析

Influencing factors of outcome of blastocysts transfer in frozen-thawed cycle

目的分析冻融囊胚移植妊娠结局的影响因素,优化囊胚移植策略。方法回顾性分析本院2016年1~12月357例患者的380个冻融囊胚移植周期的临床数据资料。按照妊娠结局分为妊娠和未妊娠2组,比较2组间囊胚发育天数、囊胚质量、移植囊胚数等因素的差异。结果与未妊娠组相比,妊娠组中D5囊胚(85.3%vs.73.6%)及优质囊胚(72.2%vs.52.9%)所占的比例均显著升高,差异有统计学意义(P<0.01)。多元Logistic回归校正后显示移植优质囊胚数与临床妊娠率显著相关(P<0.01)。结论囊胚质量对妊娠结局的影响大于囊胚发育速度,在复苏周期中应首先选择评级高的囊胚进行移植,而当囊胚评级相同时,优先移植D5囊胚。

Objective：To analysis the influencing factors of pregnancy outcomes of blastocysts transfer in frozenthawed cycles and optimize the strategy of blastocysts transfer.Methods：The clinical data of 380 frozen-thawed blastocyst transfer cycles from Jan.to Dec.2016 were retrospectively analyzed.The cycles were divided into pregnancy group and non-pregnant group.The differences of blastocyst development days,number of embryo transfer and quality of transplanting blastocysts were compared between the two groups.Results：The proportion of Day5 blastocysts（85.3% vs.73.6% ）and high quality blastocysts（72.2% vs.52.9% ）in pregnancy group were significantly higher than those in non-pregnant group（P〈0.01）.The multivariable Logistic results showed that the number of good quality blastocysts transfer was significantly associated with clinical pregnancy rate（P〈0.01）.Conclusions：The effect of blastocyst quality on pregnancy outcome is greater than the development speed of blastocyst.In the frozen-thawed cycle,the higher scoring blastocyst should firstly be chosen for transfer,and the Day5 blastocyst should be firstly chosen for transfer when the blastocysts scores are similar.