在新鲜周期预后良好的患者中实施选择性单囊胚移植的可行性

Feasibility of Selective Single Blastocyst Transplantation in Patients with Good Prognosis in the Fresh Cycle

目的探讨新鲜周期年龄在35周岁以下至少有1枚第3天(D 3)优质胚胎首次取卵移植病人行选择性单囊胚移植的可行性。方法回顾性分析2018年1月1日至2019年6月30日年龄<35岁首次在河南省人民医院生殖中心接受首次助孕治疗后至少有1枚D 3优质胚胎的新鲜移植患者的资料。按照移植胚胎数和移植胚胎时期分为单优质卵裂期胚胎移植组(A组,145例)、至少有1枚优质胚胎的双卵裂期胚胎移植组(B组,1619例)、单囊胚移植组(C组,505例)。分别比较A组与C组、B组与C组的临床妊娠结局。结果C组的临床妊娠率与种植率均高于A组(P<0.0167),C组与A组多胎率和胚胎利用率比较,差异无统计学意义(P>0.0167);C组与B组临床妊娠率比较,差异无统计学意义(P>0.05),C组种植率高于B组(P<0.0167),C组多胎率和胚胎利用率低于B组(P<0.0167)。结论新鲜周期预后良好的患者行选择性单囊胚移植可以获得较高的临床妊娠率及胚胎种植率,以及较低的多胎妊娠率。因此选择性单囊胚移植策略在预后良好的特定人群中是可行的。

Objective To investigate the feasibility of selective single blastocyst transfer in patients with at least one day 3(D 3)high quality embryo under the age of 35 in the fresh cycle for the first time.Methods Retrospective analysis of freshly transplanted patients with at least one D 3 high-quality embryo after receiving pregnancy treatment for the first time in reproductive center of Henan Provincial People’s Hospital from January 1,2018 to June 30,2019.According to the number of transferred embryos and the embryo transfer period,they were divided into single high quality embryo transfer group(group A,145 cases),double cleavage stage embryo transfer group with at least 1 high quality embryo(group B,1619 cases),single blastocyst transplantation group(group C,505 cases).The clinical pregnancy outcomes of groups A and C,and groups B and C were compared respectively.Results The clinical pregnancy rate and implantation rate in group C were higher than those in group A(P<0.0167),but there was no significant difference in multiple pregnancy rate and embryo utilization rate between group C and group A(P>0.0167).There was no significant difference in clinical pregnancy rate between group C and group B(P>0.05).The implantation rate in group C was higher than that in group B(P<0.0167),and the multiple pregnancy rate and embryo utilization rate in group C were lower than those in group B(P<0.0167).Conclusion Patients with good prognosis in the fresh cycle who choose single blastocyst transplantation can obtain higher clinical pregnancy rate and embryo implantation rate,but significantly reduce the multiple pregnancy rate.Therefore,the selective single blastocyst transfer strategy is feasible in certain populations with good prognosis.