冻融周期中移植优质囊胚数与临床结局的关系

Relationship between the number of high-quality blastocysts and clinical outcomes in frozen-thawed cycles

目的探讨在冻融周期中移植优质囊胚数与临床结局的关系。方法回顾性分析2017年1月-12月在洛阳市妇女儿童医疗保健中心行冻融囊胚移植,且患者年龄≤38岁的395个周期,按移植优质囊胚数分为单优质囊胚组(A组37周期)、双非优质囊胚组(B组76周期)、双囊胚其中一个为优质组(C组85周期)、双优质囊胚组(D组197周期)。比较各组间的临床妊娠率、着床率、多胎率和流产率。结果 A组临床妊娠率显著低于D组(P<0.05);B组着床率显著低于D组(P<0.05);A组多胎率显著低于B、C、D组(P<0.05);流产率各组间无统计学差异(P>0.05)。结论单优质囊胚移植在显著降低多胎率的同时,能够获得满意的着床率,建议≤38岁的患者首次移植选择单优质囊胚移植。双囊胚移植多胎率过高,建议适当减少。

Objective To investigate the relationship between the number of high-quality blastocysts and clinical outcomes in frozen-thawed cycles.Methods A retrospective analysis was performed in 395 frozen-thawed blastocyst transfer cycles in our center from January to December 2017,and the age of the patients was no more than 38 years old. According to the number of high-quality blastocysts, the patients were divided into single high-quality blastocyst group(group A,37 cycles), double poor-quality blastocysts group(group B,76 cycles), one of the double blastocysts is high-quality group(group C,85 cycles) and double high-quality blastocysts group(group D,197 cycles). The clinical pregnancy rate, implantation rate, multiple pregnancy rate and abortion rate were compared among the groups.Results The clinical pregnancy rate of group A was significantly lower than that of group D(P<0.05), the implantation rate of group B was significantly lower than that of group D(P<0.05), the multiple pregnancy rate of group A was significantly lower than that of group B, C and D(P<0.05), and the abortion rate was not significantly different among groups(P>0.05).Conclusion Single high-quality blastocyst transplantation can achieve satisfactory implantation rate while significantly reducing the multiple pregnancy rate. It is suggested that the single high-quality blastocyst transplantation should be selected for the first transplant in patients under the age of 38. Double blastocyst transplantation rate of multiple births is too high, suggesting appropriate reduction.