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目的 探讨卵巢高反应患者新鲜周期选择性单卵裂期胚胎移植的临床应用价值。方法 回顾性分析2015年1月至2020年9月在我院行体外受精-胚胎移植(IVF-ET)治疗的卵巢高反应患者的资料。根据移植胚胎类型分为两组：行单囊胚移植者(囊胚移植组，153例);行选择性单卵裂期胚胎移植者(卵裂胚移植组，83例)。比较两组患者的基本临床资料、促排卵治疗情况及临床结局。结果 两组患者间基本临床资料差异均无统计学意义(P>0.05)。与囊胚移植组比较，卵裂胚移植组的获卵数[(12.00±3.57)vs.(15.99±4.20)]、受精率(77.81%vs. 85.00%)、可利用胚胎数[(6.04±2.55)vs.(11.67±3.09)]、优质胚胎数[(2.23±1.56)vs.(5.79±2.63)]显著下降(P<0.05)。两组患者间HCG阳性率、临床妊娠率、流产率、异位妊娠率、多胎妊娠率、活产率、中重度OHSS发生率、分娩孕周、新生儿出生体重、出生缺陷率及妊娠期并发症发生率均无统计学差异(P>0.05),但囊胚移植组早产率显著高于卵裂胚移植组(16.22%vs. 0,P<0.05)。结论 卵巢高反应患者新鲜周期选择性单卵裂期胚胎移植可以获得与单囊胚移植相似的妊娠结局，并能降低早产率。
Abstract：Objective:To investigate the clinical application value of selective single cleavage embryo transfer in fresh cycle of patients with high ovarian response.Methods:The data of patients with ovarian hyper response who underwent IVF-ET treatment in our hospital from January 2015 to September 2020 were retrospectively analyzed. The cycles were divided into two groups by embryo stage: single blastocyst transfer group(n=153) and selective single cleavage embryo transfer group(n=83). The basic clinical data, ovulation induction status and clinical outcomes were compared between the two groups.Results:There was no significant difference in the basic clinical data between the two groups(P>0.05). Compared with the blastocyst transfer group, the number of oocyte retrieved [(12.00±3.57)vs.(15.99±4.20)],fertilization rate(77.81% vs. 85.00%),available embryos [(6.04±2.55)vs.(11.67±3.09)] and high-quality embryos [(2.23±1.56)vs.(5.79±2.63)] were significantly decreased than those in the cleavage embryo transfer group(P<0.05). There were no significant differences in HCG positive rate, clinical pregnancy rate, abortion rate, ectopic pregnancy rate, multiple pregnancy rate, live birth rate, incidence of moderate and severe OHSS,gestational weeks, newborn birth weight, birth defects rate and the incidence of pregnancy complications between two groups(P>0.05). The preterm delivery rate in the single blastocyst group was significantly higher than that in selective single cleavage embryo transfer group(16.22% vs. 0,P<0.05).Conclusions:Selective single embryo transfer in fresh cycle of patients with high ovarian response can achieve similar pregnancy outcomes as single blastocyst transfer, and can reduce the premature delivery rate.
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基本信息:
中图分类号:R714.8
引用信息:
[1]王爱爱,陆杉,徐珉,等.卵巢高反应患者新鲜周期选择性单卵裂期胚胎移植临床结局分析[J].生殖医学杂志,2022,31(04):447-452.
基金信息:
广东省中医药局科研项目(20201126)
2021-10-31
2021
2022-02-24
2022
2
2022-04-15
2022-04-15