增加1枚非优质胚胎移植对IVF-ET妊娠结局的影响

The effects of transferring an additional poor-quality embryo on IVF-ET pregnancy outcomes

目的:研究在IVF-ET的新鲜取卵周期,增加1枚非优质胚胎的移植对妊娠结局的影响。方法:回顾分析2015年1月至2018年12月在郑州大学第二附属医院生殖中心接受IVF-ET助孕的患者的资料。按移植胚胎数分为3组:移植1枚优质胚胎97个周期(组1),移植2枚优质胚胎1810个周期(组2),移植1枚优质胚胎和1枚非优质胚胎279个周期(组3)。比较3组的临床资料和妊娠结局。结果:组2的获卵数、优胚数、HCG日E 2值、P值、临床妊娠率和多胎妊娠率均高于组1,差异均有统计学意义( P <0.05)。组3的着床率明显低于组1,多胎妊娠率明显高于组1,差异有统计学意义( P <0.05),临床妊娠率与组1无显著差异。Logistics回归显示,年龄是妊娠结局的危险因素,HCG日内膜厚度是保护因素。结论:增加移植优质胚胎数可提高临床妊娠率,增加1枚非优质胚胎的移植,不能提高临床妊娠率,由于多胎妊娠率明显增高反而增加了妊娠风险。

Objective: To investigate the effects of transferring an additional poor-quality embryo on the pregnancy outcomes during the fresh ovum retrieval cycle of IVF-ET. Methods: Retrospective analysis was performed on the data of patients who received IVF-ET in the reproductive center of the Second Affiliated Hospital of Zhengzhou University from Jan.2015 to Dec.2018.They were divided into three groups according to the number of embryos transferred.Group 1 consisted 97 cycles of patients who had 1 high-quality embryo transferred,group 2 included 1810 cycles of patients who had 2 high-quality embryos transferred,and group 3 279 cycles received 1 high-quality embryo and 1 poor-quality embryo.The clinical data and pregnancy outcomes of group 2 and 3 were compared with those of group 1. Result: The number of eggs and high-quality embryos,the HCG day E 2 value and P value,clinical pregnancy rate and multiple pregnancy rate in group 2 were higher than that in group 1,with statistically significant differences( P <0.05).The implantation rate in group 3 was significantly lower than that of group 1,and the multiple pregnancy rate was significantly higher than that of group 1,with statistically significant difference ( P <0.05).There was no statistically significant difference in clinical pregnancy rate between group 3 and group 1.According to Logistics regression,age was a risk factor for pregnancy outcome,and HCG day endometrial thickness was a protective factor. Conclusion: Increasing the number of high-quality embryos can improve the clinical pregnancy rate,while adding a poor-quality embryo can't improve the clinical pregnancy rate,which increases the pregnancy risk due to the significantly higher multiple pregnancy rate.