新鲜周期单囊胚移植314例临床结局

目的 探讨新鲜周期单囊胚移植(single blastocyst transfer,SBT)的可行性。方法 回顾性分析314个新鲜周期行SBT患者的临床资料,从年龄、囊胚分级等方面比较分析临床结局。结果 妊娠组患者的年龄显著低于未妊娠组(P0.001);选择性SBT(elective SBT,eSBT)组的临床妊娠率显著高于非选择性SBT(non-elective SBT,non-eSBT)组(P0.05);年龄≤35岁的患者,eSBT组的临床妊娠率与双囊胚移植(double blastocyst transfer,DBT)组无统计学差异,但多胎妊娠率显著降低(P0.001);而35岁的患者,eSBT组的临床妊娠率低于DBT组(P0.05),组间的多胎妊娠率无统计学差异(P0.05);囊胚扩张和孵化的程度与临床妊娠率显著相关,优质囊胚可获得更好的妊娠结局。结论 妊娠结局与囊胚的质量及患者的年龄显著相关,对于年龄≤35岁,有优质囊胚的患者,可以进行SBT。

A retrospective analysis of the clinical outcome of 314 cases of single blastocyst transfer in fresh stimulation cycles

Objective To investigate the feasibility of single blastocyst transfer (SBT).Methods A retrospective analysis was carried out on patients who performed SBT in fresh stimulation cycles,which contained 314 cycles.Clinical outcomes according to the ages and embryo qualities were analyzed.Results The ages of the patients in the clinical pregnancy group (CP group) were effectively lower than that in non-clinical pregnancy group (non-CP group)(P＜0.001).The clinical pregnancy rate in the elective single blastocyst transfer group (eSBT group) was effectively higher than that in non-elective single blastocyst transfer group (non-eSBT group)(P＜0.05).The pregnancy rates had no statistical significance between eSBT group and double blastocyst transfer group (DBT group)(P＞0.05) when patients were under 35 years old.While the multiple pregnancy rate was markedly reduced in the eSBT group (P＜0.001).The clinical pregnancy rate was higher in DBT group than in eSBT group when patients were over 35 years old,which had a statistical significance (P＜0.05).The clinical pregnancy rate was closely related to the expansion and hatching (EH) stage and the quality of the blastocyst transferred.Conclusion The clinical pregnancy rate closely related to the patients' ages and the quality ofblastocyst transferred,eSBT can be applied to women under 35 years with top-quality embryos.