摘要
目的:探讨过夜培养对早卵裂期冻融胚胎移植(FET)妊娠结局的影响。方法:回顾性分析2015年1月至2016年12月在河北医科大学第二医院行FET的3443例患者(4294周期)的临床资料,患者年龄≤38岁、移植胚胎数为2胚、子宫内膜在8~15 mm,按解冻后培养时间的不同将患者分为:过夜培养组(解冻后培养26~27小时后移植,共693周期)和短时培养组(解冻后培养4~6小时解冻日移植,共3601周期),比较以上两组患者的妊娠结局。结果:(1)过夜培养组和短时培养组FET患者的临床妊娠率分别为51.23%(355/693)和55.60%(2002/3601),异位妊娠率分别为1.13%(4/355)和3.05%(61/2002),差异有统计学意义(P<0.05),而两组种植率、多胎率、流产率差异无统计学意义(P>0.05)。(2)在全胚冷冻行首次FET患者中,两组临床妊娠率、种植率、流产率、异位妊娠率差异均无统计学意义(P>0.05),过夜培养组的多胎率57.35%(39/68)高于短时培养组44.30%(400/903),差异有统计学意义(P<0.05)。(3)在FET≥3次患者中,两组患者的临床妊娠率、胚胎种植率、流产率、异位妊娠率、多胎率差异均无统计学意义(P>0.05)。结论:早卵裂期胚胎解冻后过夜培养移植的妊娠结局并不优于解冻日移植,且过夜培养并不能改善多次FET失败患者的妊娠情况,同时全胚冷冻行首次FET的患者过夜培养仅使多胎妊娠有所增加,可以行单胚胎移植,以避免多胎妊娠发生。
Objective：To investigate the influence of overnight culture on pregnancy outcome of frozen thawed embryo transfer （FET）. Methods：The clinical data of 4294 cycles of 3443 patients who underwent FET from Jan- uary 2015 to December 2016 in the second hospital of Hebei medical university were retrospectively analyzed. The inclusion criteria were as follows：age of the patients was ≤38 years old,all patients were transferred two embryos,the endometrium of patients were 8 -15ram. According to the different culture time after thawing, the pa- tients were divided into two groups：the overnight culture group （624 cases,693 cycles） and short time culture group（3055 cases,3601 cycles）. The pregnant outcome was compared between the two groups. Results：①the clinical pregnancy rate of the overnight culture group and short time culture group were 51.23% （355/693） and 55.60% （2002/3601）, the ectopic pregnancy rate were 1.13% （4/355） and 3.05% （61/2002） respectively, the differences were statistically significant（ P 〈0.05） ,there was no significant difference between two groups in im- plantation rate, multiple pregnancy rate and abortion rate（ P 〉0.05）. ②There was no significant difference in clinical pregnancy rate,implantation rate,abortion rate and ectopic pregnancy rate among the first FET patients with all embryos cryopreservation cycles. But multiple pregnancy rates were 57.35% （39/68）in the overnight culture group and 43.41% （400/903）in short time culture group respectively, the difference was statistically significant （ P 〈 0.05）. ③In the patients with more than 3 times FET,there was no significant difference in clinical pregnancy rate,implantation rate,abortion rate, ectopic pregnancy rate and multiple pregnancy rate among the two groups （ P 〉 0.05）. Conclusions：Overnight culture does not increase the clinical pregnancy rate of early cleavage stage embryo transfer in the FET cycles,and overnight culture also cannot improve the pregnancy outcome in patients that with repeatedly FET implantation failure cycles,at the same time,overnight culture of the first time FET patients with all embryos cryopreservation cycles just increase the multiple pregnancy, single embryo transfer can be considered to avoid multiple pregnancy.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2017年第12期926-929,共4页
Journal of Practical Obstetrics and Gynecology
关键词
过夜培养
冻融胚胎移植
卵裂期
种植率
妊娠率
Overnight culture
Frozen thawed embryo transfer
Cleavage stage
Implantation rate
Pregnancy rate
