摘要
目的分析体外受精-胚胎移植新鲜周期中有异位妊娠(ectopic pregnancy,EP)病史患者移植不同级别D3胚胎和D5囊胚的妊娠结局。方法回顾性分析2010年6月~2020年5月在郑州大学第一附属医院生殖医学中心行辅助生殖助孕治疗后获得临床妊娠的3314例有EP病史的患者,根据胚胎发育天数和胚胎等级分为两组,即D3组(n=2830)和D5组(n=484),比较不同组间的妊娠结局。采用单因素和多因素Logistic回归分析评价影响重复性异位妊娠(recurrent ectopic pregnancy,REP)的因素。结果D5囊胚移植的REP率显著低于D3胚胎移植(P<0.05)。移植D3胚胎、移植日子宫内膜厚度<8mm及既往EP次数是发生REP的独立危险因素(P<0.05)。3期囊胚与4期囊胚、优质囊胚与非优质囊胚的REP发生率相似(P>0.05)。移植单枚优质D3胚胎与移植1枚优质和1枚非优质D3胚胎的REP率比较,差异无统计学意义(P>0.05);移植2枚优质D3胚胎与移植1枚优质和1枚非优质D3胚胎的REP率比较,差异无统计学意义(P>0.05)。结论在有EP病史的患者中,D5囊胚移植可显著降低新鲜周期REP率;D5囊胚整体形态学等级不影响REP率,移植1枚非优质胚胎不影响D3双胚胎移植时的REP率。
Objective To analyze the pregnancy outcomes of different grades of D3 embryo and D5 blastocyst in patients with ectopic pregnancy(EP)history during the fresh cycles of in vitro fertilization-embryo transfer(IVF-ET).Methods The clinical data of 3314 fresh cycles from patients that had EP history and achieved clinical pregnancy after IVF-ET treatment in the First Affiliated Hospital of Zhengzhou University from June 2010 to May 2020 were analyzed retrospectively.According to the days of embryo development and embryo grade,they were divided into two groups:D3group(n=2830)and D5group(n=484),and the pregnancy outcomes were compared between the two groups.Univariate and multivariate Logistic regression analysis was carried out to explore the risk factors of recurrent ectopic pregnancy(REP).Results The REP rate in D5group was significantly lower than D3group(P<0.05).D3 embryo transfer,higher number of previous EP and endometrial height<8mm on ET day were independent risk factors of REP.The degree of blastocoel expansion(grade 3 and grade 4)and morphologic grade(≥3BB and<3BB)didn′t influence REP rate.For D3 embryo transfer,there was no significant difference in the REP rate of single high-quality embryo group and double embryos group with one high-quality and one low-quality embryo(P>0.05).There was no significant difference in the REP rate of two high-quality embryos group and double embryos group with one high-quality and one low-quality embryo group(P>0.05).Conclusion For patients with EP history,D5 blastocyst transplantation can significantly reduce the incidence of REP in fresh cycles.The overall morphologic grade of D5 blastocyst had no influence on REP rate,For double D3 embryos transfer,the transfer of one poor-quality embryo didn′t increase the REP rate.
作者
焦芸云
王苑
宋宁
宛颖
宋文妍
JIAO Yunyun;WANG Yuan;SONG Ning(Reproductive Medicine Center,The First Affiliated Hospital of Zhengzhou University,Henan 450052,China)
出处
《医学研究杂志》
2023年第3期27-31,共5页
Journal of Medical Research
基金
国家自然科学基金资助项目(81871206)
河南省医学科技攻关省部共建重点项目(SBGJ202102110)。
关键词
辅助生殖技术
重复性异位妊娠
卵裂期胚胎
囊胚
Assisted reproductive technology
Recurrent ectopic pregnancy
Cleavage embryo
Blastocyst