体外受精-胚胎移植短方案周期中移植胚胎数与临床妊娠结局的关系

目的:探讨体外受精-胚胎移植(IVF-ET)短方案周期中移植不同胚胎数对于临床妊娠率和多胎发生率的影响。方法:回顾性分析2002.01-2004.10期间进行第一次IVF-ET短方案周期治疗、年龄<35岁的患者1463例,将2002.01-2003.09间移植2个胚胎者为A组(n=84)、移植3个胚胎者为B组(n=716);2003.10-2004.10期间移植2个胚胎者为C组(n=663)。分析和比较3组的可移植胚胎数、胚胎种植率、临床妊娠率和多胎发生率等。结果:B组的可移植胚胎数(7.8±3.7)显著高于移植2个胚胎的A组(4.6±4.7)和C组(6.9±3.9),P均<0.05,胚胎种植率各组间无显著性差异(A:20.62%,B:14.88%,C:21.66%),P均>0.05。B组的临床妊娠率(42.96%)显著高于A组(25.93%)和C组(39.06%),P均<0.05;各组间的单胎妊娠率无显著性差异(A:27.19%,B:20.99%,C:29.42%,P均>0.05);A组(4.94%)和C组(10.06%)的多胎妊娠率均比B组(15.77%)显著降低,P<0.05。结论:IVF-ET短方案周期中,减少移植胚胎数可能会降低临床妊娠率,但移植2枚胚胎能够有效降低多胎妊娠的发生。

Effect of Embryo Transferred Number on the Clinical Outcome in Short Term IVF/ICSI

Objective:To investigate the impact of the different embryo transferred number on the clinical pregnancy rate and the multiple pregnancy rate.Methods:A total of 1 463 cycles that performed the first short term IVF/ICSI treatment in the patients aged <35 years were selected from Jan.2002 to Oct.2004.It was divided into 3 groups,2-embryo group(84 cycles)and 3-embryo group(716 cycles)from Jan.2002 to Sep.2003,2-embryo group(663 cycles)from Oct.2003 to Oct.2004.The numbers of the available transferred embryo,the implantation rate,the clinical pregnancy rate and the multiple pregnancy rate were compared among 3 groups.Results:The implantation rate and the incidence of singleton were similar between 2-embryo group and 3-embryo group(20.62% vs 14.88%,20.62% vs 21.66%,P >0.05;27.19% vs 20.99%,27.19% vs 29.42%,P >0.05).The number of the available transferred embryo and the clinical pregnancy rate in 3-embryo group was significantly higher than those in 2-embryo group respectively(7.77±3.70 vs 4.62±4.73,7.77±3.70 vs 6.94±3.91,P <0.05;42.96% vs 25.93%,42.96% vs 39.06%,P <0.05).However,the multiple pregnancy rate per transfer in 2-embryo group was significantly lower than that in 3-embryo group(4.94% vs 15.49%,10.06% vs 15.49%,P <0.05).Conclusion:In short term IVF/ICSI protocol,the reduction of the transferred embryo number may decrease the clinical pregnancy rate,but the transfer of two embryos can reduce the incidence of multiple pregnan-ciese fficiently.