38岁以上不孕女性ART新鲜周期优选移植策略的探讨

目的 探讨≥38岁不孕女性在辅助生殖技术(assisted reproductive technology,ART)新鲜周期优选单囊胚移植与双卵裂期胚胎移植的效果.方法 回顾性分析2019年1～12月在广西壮族自治区生殖医院≥38岁不孕女性新鲜周期双卵裂期胚胎(A组:2D3,621例)和单囊胚(B组:1D5-6,71例...

Discussion on the optimal transplantation strategy of ART fresh cycle in infertile women over 38 years old

Objective To explore the transfer strategy of single blastocyst transfer or double cleavage embryo transfer in assisted reproductive technology(ART) fresh cycle for infertile women ≥38 years old.Methods To retrospectively analyze the general data, the status of induced ovulation, embryo development and pregnancy outcome of ART in infertile women ≥38 years old with fresh cycle double cleavage embryos(group A:2D3,621 cases) and single blastocysts(group B:1D5-6,71 cases) transplanted in Reproductive Hospital of Guangxi Zhuang Autonomous Region in 2019.Results The normal fertilization rate and the rate of high-quality embryos, high-quality embryo rate for transplantation in group B were lower than those in group A(P<0.05);the clinical pregnancy rate, live birth rate, early abortion rate, late abortion rate, and premature birth rate, very low birth weight infant birth rate, average birth weight in the two groups were similar(P>0.05).The implantation rate of group B was higher than that of group A,and the multiple pregnancy rate was lower than that of group A(P<0.05);Among≥4 high-quality embryos, the implantation rate of group B was significantly higher than that of group A(P<0.05).Conclusion In order to reduce the rate of multiple pregnancy, fresh cycle ART≥38-year-old infertile women with ≥4 D3 high-quality embryos, it is recommended to prefer single blastocyst transfer;While D3 ≤3 high-quality embryos, it is recommended to choose double cleavage stage transfer under the conditions of sufficient doctor-patient communication carefully.