35周岁以下女性D5单囊胚移植结局的临床分析

Clinical analysis of pregnant outcomes of single blastocyst transfer of day 5 in the women under 35 years old

目的探讨35周岁以下患者行D5单囊胚移植的可行性。方法回顾性分析2016年1月—2019年7月期间,女方年龄≤35岁,在本中心行新鲜周期全胚冻后第一冻融移植的663个周期,根据胚胎发育天数及囊胚移植数目分为三组:D3双优胚移植组(D3双优组:n=508)、D5单囊胚移植组(D5单囊组:n=47)、D5双囊胚移植组(D5双囊组:n=108),对三组的临床结局进行比较分析。结果D5双囊组临床妊娠率高于D3双优组及D5单囊组,且差异有统计学意义(P<0.05),但D5单囊组与D3双优组相比,无统计学差异(P>0.05);D5单囊胚的多胎率低于D5双囊组及D3双优组,差异均有统计学意义(P<0.001),D3双优组的多胎率也低于D5双囊组,差异亦有统计学意义(P<0.05);D5单囊组和D5双囊组的种植率都高于D3双优组,差异都有统计学意义(分别是P<0.05,P<0.001),而D5单囊组合D5双囊组之间无统计学差异(P>0.05);但三组之间的早期流产率及宫外孕率均无统计学差异(P>0.05)。结论年龄≤35周岁的患者全胚冷冻后第一冻融移植周期选择D5单囊胚进行移植,既能获得良好的临床妊娠率和种植率,又极大降低多胎妊娠率。

Objective To investigate the clinical outcomes of the single blastocyst transfer of day 5 in the women under 35 years old.Methods A retrospective study was conducted to analyze clinical outcomes of women less than 35 years old and experienced embryo transfer in the first frozen-thawed cycles from January 2016 to July 2019 in the Center of Reproductive Medicine of Guangzhou Women and Children's Medical Center.According to the embryo developmental days and transfer blastocyst numbers,all patients were divided into three groups:double high-quality cleavage embryo transfer of day 3(n=508),single blastocyst transfer of day 5(n=47),double blastocyst transfer of day 5(n=108).The clinical outcomes were compared.Results The clinical pregnancy rate of the double blastocyst transfer of day 5 was higher than the other two groups,and the differences were statistically significant(P<0.05).However,there was no statistical difference between the single blastocyst transfer of day 5 and the double high-quality cleavage embryo transfer of day 3(P>0.05).The multiple pregnancy rate of the single blastocyst transfer of day 5 was lower than the other two groups,and the differences were statistically significant(P<0.001),and that of the double high-quality cleavage embryo transfer of day 3 was even lower than that of the double blastocyst transfer of day 5,and the difference was statistically significant(P<0.05).The implanting rate of the double high-quality cleavage embryo transfer of day 3 was lower than the other two groups,and the differences were statistically significant(P<0.05;P<0.001),but there was no statistical difference between the single blastocyst transfer of day 5 and the double blastocyst transfer of day 5(P>0.05).However,the early miscarriage rate and the ectopic pregnancy rate did not exhibit statistical differences(P>0.05).Conclusion Single blastocyst transfer of day 5 can ensure clinical pregnancy rate and implantation rate while effectively reducing multiple pregnancy in the women undergoing the first frozen-thawed cycles of under 35 years old.