Background Embryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET）. There is no consensu...Background Embryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET）. There is no consensus of the optimal transfer strategy for normal responders or high responders. The current study aimed to find the optimal transfer strategy for different subgroups of patients. Methods From April 2010 to December 2010, patients who meet the following criteria were included in this study; primary infertility, female age 〈35 years, FSH level on female cycle day 2-3 〈12 mlU/ml, at least six good quality embryos available on day three.The clinical outcomes using different transfer strategies between normal responders and high responders were reviewed and compared. Results For the normal responders, the clinical pregnancy rate of day three double-embryo transfer （DET） was comparable to that of day five elective single blastocyst transfer （eSBT）, 64.04% vs. 60.33% （P〉0.05）. For the high responders, the clinical pregnancy rate of day five eSBT was significantly lower than that of day three DET, 43.35% vs. 57.21% （P〈0.05）. For the high responders, the rates of clinical pregnancy and implantation in frozen-thawed embryo transfer （FET） cycles were notably higher than in eSBT cycles （64.56% vs. 43.35% and 62.11% vs. 43.35% respectively） （P〈0.05）. Conclusions For normal responders, eSBT might be an applicabte strategy to reduce multiple pregnancy rates while maintaining acceptable overall pregnancy rates. And in order to reduce multiple pregnancies and increase the chance of pregnancy of high responders, FET may be a preferable strategy.展开更多
目的比较选择性卵裂期单个优质胚胎移植与双优质胚胎移植的妊娠分娩结局。方法回顾性分析2014年1月~2015年10月在广州市妇女儿童医疗中心生殖医学中心实施体外受精胚胎移植治疗年轻患者239例,选择单个卵裂期优质胚胎进行移植的年轻患者3...目的比较选择性卵裂期单个优质胚胎移植与双优质胚胎移植的妊娠分娩结局。方法回顾性分析2014年1月~2015年10月在广州市妇女儿童医疗中心生殖医学中心实施体外受精胚胎移植治疗年轻患者239例,选择单个卵裂期优质胚胎进行移植的年轻患者39例为研究组,同期移植2个优质胚胎的年轻患者200例对照组。分析比较两组间临床妊娠结局及分娩结局。结果两组平均年龄、体质量指数、基础内分泌、不孕年限、HCG日子宫内膜厚度无统计学差异(P>0.05);单胚胎移植组HCG日雌激素水平、获卵数高于双胚胎移植组,总Gn用量低于双胚胎移植组(P<0.05);单胚胎移植组胚胎着床率为56.4%,高于双胚胎移植组的37.8%(P<0.05);两组临床妊娠率和活产率无统计学差异(56.4%vs 66.0%,48.7%vs 51.5%,P>0.05)。单胚胎移植组无1例多胎妊娠,而双胚胎移植组双胎妊娠率为22.7%(P<0.05)。单胚胎移植组分娩孕周、新生儿出生体质量明显高于双胚胎移植组(38.7周vs 37.8周,3.3 kg vs 2.9 kg,P<0.05);早产率在单胚胎组仅为10.5%,低于双胚胎移植组27.2%,但差异无显著性。单胚胎移植组无1例低体质量儿出生,而双胎组低体质量儿比例占22.6%(P<0.05)。结论卵裂期选择性单胚胎移植与双胚胎移植相比,可明显降低双胎率,对活产率无影响,同时可以获得更好的产科结局。展开更多
目的探讨第3日选择性单胚胎移植(elective single embryo transfer,eSET)在临床上的应用价值。方法回顾性分析2014年5月至2019年3月期间在天津市第一中心医院生殖医学科予常规体外受精/卵胞质内单精子显微注射(IVF/ICSI)助孕治疗且年龄...目的探讨第3日选择性单胚胎移植(elective single embryo transfer,eSET)在临床上的应用价值。方法回顾性分析2014年5月至2019年3月期间在天津市第一中心医院生殖医学科予常规体外受精/卵胞质内单精子显微注射(IVF/ICSI)助孕治疗且年龄≤38岁患者的临床资料。新鲜与解冻周期分别统计,按照移植胚胎数目,分为单胚胎移植组、双胚胎移植组;按照胚胎质量,分为单优质胚胎移植组、双优质胚胎移植组及单优质胚胎搭配非优质胚胎移植组(一优一非组);另外,解冻周期单胚胎与双胚胎移植组再细分为卵裂胚组与囊胚组,分别比较各组间患者的临床妊娠结局。结果在新鲜周期中,单胚胎与双胚胎移植组患者的临床妊娠率与早期流产率组间差异无统计学意义(P>0.05),双胚胎移植组种植率(36.22%)低于单胚胎移植组(50.77%,P=0.002),而多胎妊娠率(29.86%)高于单胚胎移植组(0%,P<0.001);在解冻周期中,单胚胎与双胚胎移植组临床妊娠率、种植率与早期流产率差异均无统计学意义(P>0.05),双胚胎移植组多胎妊娠率(30.35%)高于单胚胎移植组(2.50%),差异有统计学意义(P<0.001)。新鲜与解冻周期单优质胚胎组、双优质胚胎组及一优一非组3组间患者的临床妊娠率、早期流产率差异均无统计学意义(P>0.05),新鲜周期单优质胚胎组多胎妊娠率(0%)显著低于双优质胚胎组(32.21%)及一优一非组(6.98%,P<0.001),解冻周期单优质胚胎组多胎妊娠率(0%)显著低于双优质胚胎组(33.47%)及一优一非组(16.67%,P<0.001)。解冻周期卵裂胚组与囊胚组单胚胎与双胚胎移植组患者临床妊娠率、种植率、早期流产率、多胎妊娠率差异均无统计学意义(P均>0.05)。结论对于有1~2个优质胚胎,特别是多胎相关风险高的患者更适合行第3日移植。第3日eSET是一个能更好地降低多胎妊娠风险的移植策略,选择优质胚胎移植或冷冻,非优质胚胎继续培养如形成囊胚根据评分进行冷冻。解冻移植仍获得较好的临床妊娠率,具有较高的利用价值。展开更多
文摘Background Embryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET）. There is no consensus of the optimal transfer strategy for normal responders or high responders. The current study aimed to find the optimal transfer strategy for different subgroups of patients. Methods From April 2010 to December 2010, patients who meet the following criteria were included in this study; primary infertility, female age 〈35 years, FSH level on female cycle day 2-3 〈12 mlU/ml, at least six good quality embryos available on day three.The clinical outcomes using different transfer strategies between normal responders and high responders were reviewed and compared. Results For the normal responders, the clinical pregnancy rate of day three double-embryo transfer （DET） was comparable to that of day five elective single blastocyst transfer （eSBT）, 64.04% vs. 60.33% （P〉0.05）. For the high responders, the clinical pregnancy rate of day five eSBT was significantly lower than that of day three DET, 43.35% vs. 57.21% （P〈0.05）. For the high responders, the rates of clinical pregnancy and implantation in frozen-thawed embryo transfer （FET） cycles were notably higher than in eSBT cycles （64.56% vs. 43.35% and 62.11% vs. 43.35% respectively） （P〈0.05）. Conclusions For normal responders, eSBT might be an applicabte strategy to reduce multiple pregnancy rates while maintaining acceptable overall pregnancy rates. And in order to reduce multiple pregnancies and increase the chance of pregnancy of high responders, FET may be a preferable strategy.
文摘目的比较选择性卵裂期单个优质胚胎移植与双优质胚胎移植的妊娠分娩结局。方法回顾性分析2014年1月~2015年10月在广州市妇女儿童医疗中心生殖医学中心实施体外受精胚胎移植治疗年轻患者239例,选择单个卵裂期优质胚胎进行移植的年轻患者39例为研究组,同期移植2个优质胚胎的年轻患者200例对照组。分析比较两组间临床妊娠结局及分娩结局。结果两组平均年龄、体质量指数、基础内分泌、不孕年限、HCG日子宫内膜厚度无统计学差异(P>0.05);单胚胎移植组HCG日雌激素水平、获卵数高于双胚胎移植组,总Gn用量低于双胚胎移植组(P<0.05);单胚胎移植组胚胎着床率为56.4%,高于双胚胎移植组的37.8%(P<0.05);两组临床妊娠率和活产率无统计学差异(56.4%vs 66.0%,48.7%vs 51.5%,P>0.05)。单胚胎移植组无1例多胎妊娠,而双胚胎移植组双胎妊娠率为22.7%(P<0.05)。单胚胎移植组分娩孕周、新生儿出生体质量明显高于双胚胎移植组(38.7周vs 37.8周,3.3 kg vs 2.9 kg,P<0.05);早产率在单胚胎组仅为10.5%,低于双胚胎移植组27.2%,但差异无显著性。单胚胎移植组无1例低体质量儿出生,而双胎组低体质量儿比例占22.6%(P<0.05)。结论卵裂期选择性单胚胎移植与双胚胎移植相比,可明显降低双胎率,对活产率无影响,同时可以获得更好的产科结局。
文摘目的探讨第3日选择性单胚胎移植(elective single embryo transfer,eSET)在临床上的应用价值。方法回顾性分析2014年5月至2019年3月期间在天津市第一中心医院生殖医学科予常规体外受精/卵胞质内单精子显微注射(IVF/ICSI)助孕治疗且年龄≤38岁患者的临床资料。新鲜与解冻周期分别统计,按照移植胚胎数目,分为单胚胎移植组、双胚胎移植组;按照胚胎质量,分为单优质胚胎移植组、双优质胚胎移植组及单优质胚胎搭配非优质胚胎移植组(一优一非组);另外,解冻周期单胚胎与双胚胎移植组再细分为卵裂胚组与囊胚组,分别比较各组间患者的临床妊娠结局。结果在新鲜周期中,单胚胎与双胚胎移植组患者的临床妊娠率与早期流产率组间差异无统计学意义(P>0.05),双胚胎移植组种植率(36.22%)低于单胚胎移植组(50.77%,P=0.002),而多胎妊娠率(29.86%)高于单胚胎移植组(0%,P<0.001);在解冻周期中,单胚胎与双胚胎移植组临床妊娠率、种植率与早期流产率差异均无统计学意义(P>0.05),双胚胎移植组多胎妊娠率(30.35%)高于单胚胎移植组(2.50%),差异有统计学意义(P<0.001)。新鲜与解冻周期单优质胚胎组、双优质胚胎组及一优一非组3组间患者的临床妊娠率、早期流产率差异均无统计学意义(P>0.05),新鲜周期单优质胚胎组多胎妊娠率(0%)显著低于双优质胚胎组(32.21%)及一优一非组(6.98%,P<0.001),解冻周期单优质胚胎组多胎妊娠率(0%)显著低于双优质胚胎组(33.47%)及一优一非组(16.67%,P<0.001)。解冻周期卵裂胚组与囊胚组单胚胎与双胚胎移植组患者临床妊娠率、种植率、早期流产率、多胎妊娠率差异均无统计学意义(P均>0.05)。结论对于有1~2个优质胚胎,特别是多胎相关风险高的患者更适合行第3日移植。第3日eSET是一个能更好地降低多胎妊娠风险的移植策略,选择优质胚胎移植或冷冻,非优质胚胎继续培养如形成囊胚根据评分进行冷冻。解冻移植仍获得较好的临床妊娠率,具有较高的利用价值。
