Time-lapse培养与常规培养卵裂期胚胎移植的妊娠及新生儿结局分析

Comparison of pregnancy and neonatal outcomes between time-lapse and conventional culture of cleavage embryo transfer

目的比较时差成像(time-lapse,TL)系统培养与常规培养卵裂期胚胎移植的妊娠和新生儿出生结局,评价TL技术的安全性。方法回顾性分析2016年1月至2019年3月在本中心行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕治疗的1999周期临床资料,根据胚胎培养方式,分为time-lapse组(n=871)和常规组(n=1128),比较两组的妊娠和新生儿结局。结果两组移植日内膜、异位妊娠率、早期流产率、晚期流产率、多胎率、早产率、不良新生儿结局、低体质量儿、极低体质量儿、巨大儿、分娩孕周、新生儿体重、畸形率及男女性别比之间差异均无统计学意义(P>0.05);TL组的移植胚胎数明显少于常规组,差异有统计学意义(P<0.05);TL组的临床妊娠率、着床率、活产率及抱婴回家率明显高于常规组,差异有统计学意义(P<0.05)。结论TL培养可改善IVF妊娠结局,对新生儿出生结局无不良影响,该技术是胚胎培养的安全有效方法。

Objective To compare the perinatal outcomes of cleavage embryo transfer using time-lapse(TL)and conventional culture and evaluate the security of TL.Methods Aretrospective analysis on clinical data of 1,999 IVF/ICSI-ET cycles in our center from January 2016 to March 2019 were performed.According to the method of embryo culture,they weredivided into TL group(n=871)and conventional group(n=1128)and the perinatal outcomes in the two groups were compared.Results There was no significant difference in the two groups in terms of endometrium,ectopic pregnancy rate,early abortion rate,late abortion rate,multifetation rate,premature birth rate,adverse neonatal outcome,extremely Low birth weight infants,very low birth weight infant,macrosomic infant,gestational weeks,neonatal weight,malformation rate and sex ratio(P>0.05).The numbers of transplanted embryos in the TL group were significantly less than those in the conventional group(P<0.05).Clinical pregnancy rate,implantation rate,live birth rate and the rate of holding babieshome in the TL group were significantly higher than those in the conventional group(P<0.05).Conclusion Without adverse effects on perinatal outcomes of offspring,TL can significantly improve IVF/ICSI clinical outcomes.It is a safe and effective method for embryo culture.