非选择性单胚胎移植的周期结局分析

目的探讨非选择性单胚胎移植(non-elective single embryo transfer,non-e SET)的妊娠结局和相关因素对妊娠结局的影响。方法回顾性分析2008年1月~2013年5月在笔者中心实施的体外受精-胚胎移植周期中行非选择性单胚胎移植的181个周期,分析不同的体外受精方式、胚胎质量和促排卵方案对非选择性单胚胎移植妊娠结局的影响。结果非选择性单胚胎移植的临床妊娠率为12.71%。单精子胞质内注射(ICSI)组的正常受精率(2PN率)显著高于常规体外受精(IVF)组(75.48%vs 56.46%,P<0.05),但是临床妊娠率(16.36%vs 11.11%,P>0.05)差异无统计学意义;A级胚胎组的临床妊娠率(28.26%)显著高于B级胚胎组(9.52%)、C级胚胎组(6.89%)、D级胚胎组(6.25%)的各组临床妊娠率,差异有统计学意义(P<0.05)。长方案组的临床妊娠率与微刺激组相比差异无统计学意义(16.39%vs 14.29%,P>0.05),因此采用微刺激方案实施治疗可能具有更高的性价比。结论非选择性单胚胎移植的临床妊娠率与胚胎质量相关。

Analysis of Outcome of Non-elective Single Embryo Transfer Cycle

Objective To analyze the pregnant outcomes of non-elective single embryo transfer (non-eSET) and investigate effect of related factors on the clinical pregnancy rate of non-eSET. Methods A retrospective analysis was carried out on in vitro fertilization-embryo transfer (IVF-ET) cycles between January 2008 and May 2013,and only one embryo was available to transfer in 181 cycles. The effect of diffenent insemination methods, embryo quality and different controlled ovarian hyperstimulation protocols was studied. Results The average clinical pregnancy rate was 12.71% in the 181 non-eSET cycles. The rate of 2PN in the intracytoplasmic sperm injection (ICSI) group was significantly higher than that in the IVF group(75.48% vs 56.46%, P < 0.05). But the clinical pregnant rates(16.36%vs 11.11%,P > 0.05)had no statistically significant difference. The clinical pregnancy rates were 28.26%, 9.52%, 6.89% and 6.25% in the A embryo group, B embryo group, C embryo group and D embryo group respectively, and the clinical pregnancy rate of A embryo group was significantly higher than other three groups (P < 0.05). The clinical pregnancy rate of the long protocol group was just a little higher than the mild stimulation protocol group(16.39% vs 14.29%, P > 0.05), so the the mild stimulation protocol group may have higher cost-effectiveness. Conclusion The clinical pregnancy rate closely related to the embryo quality in the non-eSET cycles.