单囊胚冻融移植周期中囊胚质量对妊娠结局和新生儿结局的影响

Effect of blastocyst quality on pregnancy and neonatal outcomes in frozen-thawed single-blastocyst transfer cycle

目的观察单囊胚冻融移植周期中囊胚质量不同对妊娠结局及新生儿结局的影响。方法回顾性分析2593个单囊胚冻融移植周期患者的临床资料,采用Gardner囊胚评分体系评估囊胚质量,根据移植囊胚质量分为优质囊胚组(n=1727)和非优质囊胚组(n=866)。比较两组间的妊娠结局和新生儿结局。结果优质囊胚组着床率、临床妊娠率、活产率均高于非优质囊胚组(均P<0.05),而两组间异位妊娠率、早期流产率、多胎妊娠率、引产率及母体并发症发生率比较,差异无统计学意义(均P>0.05)。优质囊胚组男性新生儿比例高于非优质囊胚组(P<0.05),但两组新生儿分娩方式、出生时孕周、出生体重、早产儿比例、低出生体重儿比例、极低出生体重儿比例、巨大儿比例、出生缺陷发生率比较,差异均无统计学意义(均P>0.05)。结论单囊胚冻融移植周期中,囊胚质量虽然会影响母体妊娠率和活产率,但移植质量较差的囊胚并不会增加围生期不良结局和新生儿缺陷的发生率。

Objective To observe the effects of different blastocyst quality on pregnancy and neonatal outcomes in frozen-thawed single-blastocyst transfer cycle.Methods The clinical data of 2593 patients who received frozen-thawed single-blastocyst transfer were retrospectively analyzed,the Gardner blastocyst scoring system was employed to evaluate blastocyst quality,and the patients were divided into good-quality blastocyst group(n=1727)and poor-quality blastocyst group(n=866)in accordance with their blastocyst quality.Pregnancy and neonatal outcomes were compared between the two groups.Results The implantation rate,clinical pregnancy rate,and live birth rate in the good-quality blastocyst group were higher than those in the poor-quality blastocyst group(all P<0.05),whereas there were no statistically significant differences in ectopic pregnancy rate,early abortion rate,multiple pregnancy rate,induced labor rate,or incidence rate of maternal complications between the two groups(all P>0.05).The proportion of male neonates in the good-quality blastocyst group was higher than that in the poor-quality blastocyst group(P<0.05),however,no statistically significant differences were found between the two groups in delivery modes,gestational weeks or weight at birth,preterm birth rate,low birth weight rate,very low birth weight rate,macrosomia rate,or incidence rate of birth defect(all P>0.05).Conclusion In frozen-thawed single-blastocyst transfer cycle,though blastocyst quality can influence maternal pregnancy rate and live birth rate,poor-quality blastocyst for implantation may not increase incidence rates of poor perinatal outcomes and neonatal defects.