体外受精-胚胎移植中胚胎质量和女方年龄与多胎妊娠的相关性

Correlative investigation on embryo quality,female age and multiple pregnancy rates in IVF-ET cycles

目的 :观察胚胎质量和女方年龄对体外受精胚胎移植 (IVFET)中多胎妊娠发生率的影响。方法 :选择每周期移植 3～ 4个胚胎的 32 5个IVFET治疗周期 (常规IVF 16 9周期 ,ICSI 15 5周期 ) ,分析移植胚胎质量和女方年龄对临床妊娠率和多胎妊娠率的影响。结果 :32 5个周期共移植 10 4 9个新鲜胚胎 ,≤ 35岁妇女移植胚胎中含不同数目 (0 ,1,2 ,≥ 3)高质量胚胎的种植率 (P <0 .0 1)和周期临床妊娠率 (P <0 .0 1)差别有显著性 ;多胎妊娠率随着移植好质量胚胎数的增加而升高 ,98%的多胎妊娠发生在≤ 35岁妇女中。 >35岁妇女移植胚胎中含不同数目高质量胚胎的种植率 (P >0 .0 5 )和周期临床妊娠率 (P >0 .0 5 )差别无显著性。结论 :移植胚胎质量和女方年龄是两个重要的预测妊娠和多胎妊娠的因素。根据移植胚胎质量和女方年龄进行个体化的胚胎移植是必要的。

Objective:To observe the influecne of the quality of transferred embryos and female age on the multiple pregnancy rates in IVF-ET cycles.Methods:A total of 325 IVF cycles with 3～4 embryos transferred(169 routine IVF cycles,155 ICSI cycles)were included in this study. The influence of transferred embryos quality and female age on clinical pregnancy rates and multiple pregnancy rates was analyzed.Results:1049 fresh embryos were transfered in 325 cycles.There were significant differences of pregnancy rate (PR;p<0.01) and implantation rate (IR;p<0.01) when different number of top quality embryo was transferred in women age≤35. There was a tendency that more multiple pregnancies rate rose with the number of good quality transferred embryos increased in women age≤35. The multiple pregnancy rate was 98% in women of age ≤35. There was no significant difference in IR and PR when different numbers of top quality embryo were transferred in women age >35 (P>0.05).Conclusion:The quality of transferred embryos and female age are two important factors for forecasting both PR and multiple PR. Most multiple pregnancies occurred in women of age ≤35. It was necessary that an individualized embryo transfer policy should be implemented based on the quality of transferred embryos and female age.