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目的 探讨体外受精-胚胎移植过程中D3卵裂期“废弃”胚胎与可用胚胎培养发育形成的低质量单囊胚移植对妊娠和围产结局的影响。方法 回顾性分析2018年1月至2023年12月在我院行低质量单囊胚移植的患者临床资料，共360个周期。根据移植囊胚的来源即D3胚胎质量将患者分为两组：可用胚胎培养组(A组，321个周期，其中来源于优质胚胎培养的单囊胚移植61个周期进一步定义为A1组)和“废弃”胚胎试培养组(B组，39个周期);比较A、B两组间及A1组、B组间的临床妊娠及围产结局。结果 A、B两组的一般资料比较均无显著性差异(P>0.05)。B组的获卵数及双原核(2PN)数显著低于A组(P<0.05),D3胚胎形态学参数与A组有显著性差异(P<0.05)。与A组相比，B组的临床妊娠率(48.72%vs. 49.53%)、活产率(35.90%vs. 39.56%)有所下降，流产率略有上升(21.05%vs. 20.13%),但差异均无统计学意义(P>0.05);两组的妊娠期并发症发生率及新生儿身长、体重比较均无显著性差异(P>0.05)。进一步分析A1组与B组的结果显示，两组间的临床妊娠率、活产率、流产率及新生儿身长、体重比较均无显著性差异(P>0.05)。结论 在没有可用胚胎的情况下，选择“废弃”胚胎试培养形成的低质量囊胚移植后可以获得尚满意的妊娠结局，但未来仍需要更多的数据积累，验证其对妊娠结局及儿童生长发育的影响。
Abstract：Objectives:To explore the differences in pregnancy and perinatal outcomes between low-quality single blastocyst transfer from “discarded” embryos on day 3 of cleavage and available-cultured embryos.Methods:A retrospective analysis was conducted on the clinical data of patients who underwent low-quality single blastocyst transfer in Northwest Women's and Children's Hospital from January 2018 to December 2023(360 cycles in total). Patients were divided into two groups based on the source of the transferred blastocyst, namely, the available embryo culture group(group A,321 cycles, in which 61 cycles underwent single blastocyst transfer with high-quality embryos were further defined as group A1) and the “discarded” embryo trial culture group(group B,39 cycles). The clinical pregnancy outcomes and perinatal outcomes were compared between group A and group B as well as between group A1 and group B.Results:There was no significant difference in baseline characteristics between group A and group B(P>0.05). The number of retrieved oocytes and the number of double prokaryotic nuclei(2PN) in group B were significantly lower than those in group A(P<0.05),and there were significant differences in the morphological parameters of D3 embryos between group A and group B(P<0.05). Compared with group A,the clinical pregnancy rate(48.72% vs. 49.53%) and live birth rate(35.90% vs. 39.56%) in group B were slightly lower, while the miscarriage rate was slightly higher(21.05% vs. 20.13%),but the differences were not statistically significant(P>0.05). There were no significant differences in the incidence of pregnancy complications, newborn length and weight between the two groups(P>0.05). Further analysis of group A1 and group B showed no statistically significant differences in clinical pregnancy rate, live birth rate, miscarriage rate, the length and weight of newborns between the two groups(P>0.05).Conclusions:In the absence of available embryos, the transfer of low-quality blastocysts formed from “discarded” embryo trial culture can still achieve good pregnancy outcomes. However, further data accumulation is required to validate its impact on pregnancy outcomes and child growth and development.
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基本信息:
中图分类号:R714.8
引用信息:
[1]李波,薛侠,师娟子.不同来源的低质量单囊胚移植对妊娠和围产结局的影响[J].生殖医学杂志,2025,34(11):1480-1486.
基金信息:
陕西省卫生健康生殖医学科研创新团队(2023TD-04)