促排卵移植周期中不同卵裂球数目优势胚胎移植结局的比较

目的探讨体外受精-胚胎移植周期中移植不同卵裂球数目的优势胚胎对妊娠结局的影响。方法对我中心2008年1月-2009年10月270例来曲唑促排卵方案第三天移植的胚胎进行回顾性分析,根据不同卵裂球数目分为4组：至少一个优势胚胎8细胞组（A组）,至少一个优势胚胎7细胞组（B组）,至少一个优势胚胎6细胞组（C组）,小于6细胞组（包括4细胞和5细胞）（D组）计算各组移植后临床妊娠率、种植率,流产率。结果优势胚胎为8细胞的妊娠率和种植率最高（37.5%,19.9%）,其次是7细胞组（25%,15.9%）和6细胞组（23.8%,12.5%）,4细胞和5细胞最低（13.3%,12.1%）,各组具有统计学差异（P〈0.05）。各组流产率无显著统计学差异（P〉0.05）。结论第三天移植优势卵裂球8细胞胚胎获得更高的临床效果,细胞数目少的胚胎仍具有一定的发育潜能,不能轻易丢弃。

The association of the cell number of optimal embryo transferred and clinical pregnancy in IVF-ET cycle

Objective: To investigate the relationship between the cell number of day 3 the best embryo transferred and the clinical pregnancy rate in IVF-ET cycle.Methods This study involved 270 patients from March to November 2008.The embryos transferred on day 3 of culture were divided into four groups based on the cell numbers:group A,the cell number of the optimal embryo transferred is eight at least;group B,the cell number of the optimal embryo transferred is seven at least;group C,the cell number of embryo transferred was six;group D,the cell numbers of embryo transferred <6.Pregnancy was confirmed by ultrasound 4 weeks after embryo transferred.Results: The embryos with 8 cells resulted in the highest pregnancy rate(37.5),followed by the embryos with 7,6 cells(25%,23.8%,23.3%,respectively),while the pregnancy rates of the embryos with 4～5 cells were 13.3% unexpectedly.Conclusions: The pregnancy rate is closely related to the cell number of embryo transferred.when embryos were transferred on day 3 of culture,the highest pregnancy rate was found in the embryos with 8 cells.which should be the first choice for embryo transfer and the embryo with 7 or 6 cells ranks second,followed by the embryo with 5 or 4 cells.The embryos with ≤5 cells are also eligible for fresh transfer cycle,and no discarding easily.