冻融周期中不同发育天数单囊胚移植的临床结局比较

Clinical Outcomes of Frozen-Thawed Single Blastocyst Transfer on Different Developmental Days

目的:探讨冻融单囊胚移植周期中不同发育天数及囊胚评分对妊娠结局的影响。方法:回顾性分析2008年1月—2015年12月采取短效长方案促排卵行冻融单囊胚移植的1 675个周期的妊娠结局。根据移植囊胚的发育天数及评分分为6组:D5BB级及以上、D5BC/CB级、D5CC级、D6BB级及以上、D6BC/CB级和D6CC级,比较6组的妊娠结局。结果:6组的单胎妊娠率、双胎妊娠率、异位妊娠率、早期流产率、早产率、足月产率及低出生体质量儿率差异均无统计学意义(P>0.05);临床妊娠率、晚期流产率和活产率差异有统计学意义(均P<0.05)。组间两两比较显示D5囊胚与D6BB级及以上囊胚临床妊娠率和活产率差异均无统计学意义(P>0.05);D5BC/CB级及以上临床妊娠率及活产率高于D6BC/CB级和D6CC级,差异有统计学意义(P<0.05);D5CC级与D6囊胚临床妊娠率和活产率差异无统计学意义(P>0.05)。结论:冻融单囊胚移植周期中,移植D5优质囊胚与D6BB级及以上的囊胚,可获得较为理想的妊娠结局。

Objective：To compare the clinical outcomes of frozen-thawed single blastocyst transfer,on the different frozen day and with the different blastocyst score.Methods：This retrospective analysis included 1 675 cycles of frozen-thawed single blastocyst transfer in our IVF center from January 2008 to December 2015.Those cycles were divided into six groups,according to the frozen day and the blastocyst score.They are group D5BB and above,group D5BC/CB,group D5CC,group D6BB and above,group D6BC/CB,group D6CC.The clinical outcomes were compared among groups.Results：There were no significant differences in those rates of monocyesis,gemellary pregnancy,ectopic pregnancy,first trimester abortion,preterm birth,full-term birth,and low birth weight infant among six groups（all P＞0.05）.The rates of clinical pregnancy,late trimester abortion and live birth were significantly different （both P＜0.05）.When compared between any two groups,there were no significant differences in the rates of clinical pregnancy and live birth between group D5 blastocysts and group D6BB,or between group D5CC and group D6 blastocysts （all P ＞0.05）.Interestingly,the rates of clinical pregnancy and live birth were significantly increased in the group D5BC/CB when compared with the group D6BC/ CB and group D6CC（all P＜0.05）.Conclusions：In those frozen-thawed cycles of single blastocyst transfer,there are good clinical outcomes when do the transfers on D5 with high and mediate-grade blastocysts,and on D6 with high-grade blastocysts.