体外受精/卵胞浆内单精子注射无可移植胚胎周期危险因素的探讨

Risk factors of non-transplantable embryo cycle by in vitro fertilization/intracytoplasmic sperm injection

目的探讨体外受精/卵胞浆内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)无可移植胚胎周期的危险因素。方法去回顾性分析2015年12月至2019年7月于河北省生殖健康医院生殖中心行IVF/ICSI治疗且接受取卵手术的周期,入组3101个周期,其中无可移植胚胎168个周期,分析无可移植胚胎的因素构成;比较168个无可移植胚胎周期和2933个有可移植胚胎周期的差异。Logistic回归和森林图分析无可移植胚胎的危险因素。结果取卵后无可移植胚胎周期占总周期数的5.42%(168/3101)。无可移植胚胎因素构成顺位分别是卵裂后无可移植胚胎(43.45%)、异常受精(25.60%)、授精后未受精(19.64%)、未获卵(8.33%)和获卵后未授精(2.98%)。Logistic回归和森林图分析显示,女方高龄、基础窦卵泡(antral follicle,AFC)数和排卵前卵泡数(preovulation follicle count,PFC)少是取卵后无可移植胚胎的危险因素。结论女方高龄、AFC和PFC少可能是取卵周期无可移植胚胎的高危因素。

Objective To explore risk factors for non-transplantable embryo cycles in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI).Methods The cycles of IVF/ICSI treatment in Reproductive Medicine Center of Hebei Reproductive Health Hospital from December 2015 to July 2019 were retrospectively analyzed and introduced 3101 cycles were enrolled,among which 168 cycles were non-transferable embryos.The factors of non-transferable embryos were analyzed.The difference between 168 nontransplantable embryo cycles and 2933 transplantable embryo cycles was compared.Logistic regression analysis and forest map analysis of the risk factors of non-transplantable embryos.Results The period of no embryo transfer after ovulation accounted for 5.42%(168/3101).The factors that constituted the sequence of non-transplantable embryos were non-transplantable embryos after cleavage(43.45%),abnormal fertilization(25.60%),non-fertilization after fertilization(19.64%),no eggs were obtained(8.33%)and unfertilized after egg retrieval(2.98%).Logistic regression and forest map analysis showed that old age and less AFC and PFC were risk factors for no embryo to be transplanted after ovulation.Conclusion The advanced age of the woman and the low AFC and PFC may be the risk factors for the non-transplantable embryo during the ovulation cycle.