不同质量玻璃化冻融胚胎移植对其妊娠结局的影响

目的]探讨移植不同质量的玻璃化冻融胚胎与妊娠结局的关系,寻找合适的冻融胚胎移植选择策略,以保证妊娠率、降低多胎率.方法] 对应用玻璃化冷冻技术进行人类早期胚胎冻融移植周期492 例患者的相关资料进行回顾性分析,根据移植优质胚胎数量以及移植胚胎中包含8 细胞胚胎数目将其分为3 组,比较各类组间的临床妊娠率和多胎率差异.结果]共复苏了1 425 枚胚胎,存活1 340 枚,胚胎存活率为94.0%,其中完整胚胎1 268 枚,胚胎完整率为89.0%,临床妊娠率为43.9%,多胎率37.0%.移植3 枚优胚的妊娠率显著高于移植1～2枚优胚的妊娠率（P〈0.05）;移植1枚优胚的多胎率显著低于移植2～3枚优胚的多胎率.移植8细胞胚胎的妊娠率显著高于其他细胞数胚胎组（P〈0.05）,随着移植8细胞胚胎数目的增加,多胎率亦增加,但妊娠率无显著性差异.结论]移植的玻璃化冻融优胚数目和8细胞胚胎数是影响临床妊娠率和多胎率的重要因素.因此,为保证患者的妊娠率,降低多胎率,应移植2 枚优质胚胎,其中包含1 枚8细胞优质胚胎.

Influence of Different Quality of Vitrified Frozen-thawed Embryo Transfer on Pregnancy Outcome

Objective] To explore the relationship between different quality of vitrified frozen-thawed embryo and pregnant outcome, and find an appropriate strategy for selecting frozen-thawed embryo transfer in order to ensure the pregnancy rate and decrease multiple-pregnancy rate. Methods] The data of 492 cases of patients performed by vitrified-thaw embryos were analyzed retrospectively. According to the number of good quality embryos and the cell number of transferred embryos containing 8-cell embryos, all cases were divided into 3 groups. The differences of clinical pregnancy rate（PR） and multiple-pregnancy rate were compared among groups. Results]A total of 1425 embryos were thawed, of which 1340（94.0%） embryos survived and 1268（89.0%） embryos were complete. PR and multiple-pregnancy rate were 43.9% and 37.0%, respectively. PR of 3 embryos was significantly higher than that of 1-2 embryos（ P 〈0.05）, and multiple-pregnancy rate of one embryo transfer was significantly lower than that of 2-3 embryos transfer（ P 〈0.05）. PR of 8- cell embryo transfer was significantly higher than that of none-8-cell-embryos transfer（ P 〈0.05）. The multiple-pregnancy rate increased with the number of 8-cell embryo transfer, but PR had no significant difference. Conclusion] The number of transferred good-quality embryos and 8-cell embryos are the important factors af- fecting PR and multiple-pregnancy rate. Therefore, two good-quality embryos including one 8-cell embryos should be transferred in order to ensure PR and decrease multiple-pregnancy rate.