反复种植失败实验室影响因素

Laboratory influencing factors of recurrent implantation failure

目的探讨实验室因素在反复种植失败(recurrent implantation failure,RIF)患者中的影响。方法回顾性分析2017年1月至2021年12月在南方医科大学附属广东省人民医院(广东省医学科学院)生殖医学科行常规体外受精或卵胞浆内单精子显微注射(in vitro fertilization or intracytoplasmic sperm injection,IVF/ICSI)反复种植失败的患者57例,其中自第3次胚胎移植失败后,将在第4或第5次胚胎移植后妊娠的患者作为A组(24例)和未妊娠的作为B组(33例),采用独立样本t检验或秩和检验以及Logistic回归分析,比较两组患者实验室与临床相关因素。结果两组患者资料分析结果显示,A组与B组比较移植胚胎数差异具有统计学意义(1.67±0.48 vs 1.36±0.49,P=0.024),但两组间在基线资料、临床因素和胚胎评分方面差异无统计学意义(P>0.05),实验室因素中移植不同发育阶段的胚胎(卵裂胚,囊胚)、卵子授精方式(IVF/ICSI)和累计可利用胚胎数差异无统计学意义(P>0.05)。进一步分析两组患者从第1个周期到最后1个周期的移植数目,结果显示移植2枚囊胚将有助于改善其妊娠结局。结论对于RIF患者,移植2枚胚胎会提高妊娠成功率。

Objective To investigate the effects of laboratory factors on patients with recurrent implantation failure(RIF).Methods Clinical data of 57 cases of RIF in vitro fertilization or intracytoplasmic sperm injection(IVF/ICSI)during 2017 and 2021 were retrospectively analyzed.After the failure of the 3rd embryo transfer,patients who were pregnant after the 4th or 5th embryo transfer were divided into the pregnant group(group A,n=24)and non-pregnant group(group B,n=33).The laboratory and clinical factors of the two groups were compared with independent sample t test,rank sum test and Logistic regression.Results There was statistically significant difference in the number of embryos transferred between groups A and B(1.67±0.48 vs.1.36±0.49,P=0.024).However,there were no significant differences in baseline data,clinical factors,and embryo scores(P>0.05);there were no significant differences in the transfer of embryos at different developmental stages(cleavage embryo,blastocyst),ovum insemination methods(IVF/ICSI),and the cumulative number of available embryos(P>0.05).Further analysis of the number of transplants from the first to the last cycle indicated that transfer of two blastocysts helped improve the pregnancy outcomes.Conclusion For patients with RIF,transfer of two embryos will improve the success rate of pregnancy.