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目的比较卵裂期胚胎移植与囊胚移植在卵巢过度刺激综合征(OHSS)高危患者首次冷冻复苏周期中应用的临床结局。方法回顾性分析2014年1月至2015年6月在本中心进行体外受精的首次冷冻复苏周期OHSS高危患者,均有卵裂期胚胎冷冻和囊胚冷冻,总例数为232例,将卵裂期胚胎移植组设为A组共84例,囊胚移植组设为B组共148例;分析两组患者年龄、体重指数、基础激素水平、内膜厚度及临床结局。结果 A组患者84例,行卵裂期胚胎移植,临床妊娠61例,临床妊娠率72.62%;B组患者148例,临床妊娠125例,临床妊娠率84.46%,临床妊娠率有统计学差异(P<0.05)。两组患者的年龄、基础激素水平、体重指数、内膜厚度均无统计学意义(P>0.05)。结论在体外受精-胚胎移植中,OHSS高危患者可以优先考虑囊胚移植。
Abstract：Objective: To compare the clinical outcome of cleavage-stage embryo transfer and blastocyst transfer in the first frozen-thawed cycle in the patients with high-risk of ovarian hyperstimulation syndrome(OHSS).Methods: The data of 232 patients with high-risk of OHSS in the first frozen-thawed IVF cycle in our reproductive center from January 2014 to June 2015 were retrospectively analyzed The patients were divided into two groups:the patient with cleavage-stage embryo transfer in group A(n=84)and the patients with blastocyst transfer in group B(n=148).The patients' age,body mass index(BMI),baseline hormone levels,endometrial thickness and clinical outcomes were compared between the two groups.Results: The clinical pregnancy rate in group A was significantly lower than that in group B[72.62%(61/84)vs.84.46%(125/148)](P<0.05).There were no significant differences in age,BMI,baseline hormone levels,endometrial thickness between the two groups(P>0.05).Conclusions: The blastocyst transfer should be considered to adopt preferentially for the patients with high-risk of OHSS.
[1]Nastri CO,Teixeira DM,Moroni RM,et al.Ovarian hyperstimulation syndrome:pathophysiology,staging,prediction and prevention[J].Ultrasound Obstet Gynecol,2015.45:377-393.
[2]Tan BK,Mathur R.Management of ovarian hyperstimulation syndrome.Produced on behalf of the BFS Policy and Practice Committee[J].Hum Fertil(Camb),2013.16:151-159.
[3]Aboulghar MA,Mansour RT.Ovarian hyperstimulation syndrome:classifications and critical analysis of preventive measures[J].Hum Reprod Update,2003,9:275-289.
[4]Naredi N,Talwar P,Sandee PK.VEGF antagonist for the prevention of ovarian hyperstimulation syndrome:Current status[J].Med J Armed Forces India,2014,70:58-63.
[5]Atkinson P,Koch J,Ledger WL.GnRH agonist trigger and a freeze-all strategy to prevent ovarian hyperstimulation syndrome:a retrospective study of OHSS risk and pregnancy rates[J].Aust N Z J Obstet Gynaecol,2014,54:581-585.
[6]Gardner DK,Lane M,Stevens J,et al.Blastocyst score affects implantation and pregnancy outcome:towards a single blastocyst transfer[J].Fertil Steril,2000,73:1155-1158.
[7]Tiitinen A,Halttunen M,Harkki P,et al.Elective single embryo transfer:the value of cryopreservation[J].Hum Reprod,2001.16:1140-1144.
[8]Bechoua S,Kthouvenot A.How to demonstrate that eSET does not compromise the likelihood of having a baby?[J].Hum Reprod,2009,24:3073-3081.
[9]Griesinger G,von Otte S,Schroer A,et al.Elective cryopreservation of all pronuclear oocytes after GnRH agonist triggering of final oocyte maturation in patients at risk of developing OHSS:a prospective,observational proof-ofconcept study[J].Hum Reprod,2007.22:1348-1352.
[10]Tiitinen A,Halttunen M,Hkki P,et al.Elective single embryo transfer:the value of cryopreservation[J].Hum Reprod,2001,16:1140-1144.
[11]Aziminekoo E,Mohseni Salehi MS,Kalantari V,et al.Pregnancy outcome after blastocyst stage transfer comparing to early cleavage stage embryo transfer[J].Gynecol Endocrinol,2015,31:1-5.
[12]Papanikolaou EG,Camus M,Kolibianakis EM,et al.In vitro fertilization with single blastocyst-stage versus single cleavage-stage embryos[J].N Engl J Med,2006,354:1139-1146.
[13]Mj DLS,Mercader A,GalA,et al.Implantation rates after two,three,or five days of embryo culture[J].Placenta,2003,24:S13-S19.
[14]Papanikolaou EG,D’haeseleer E,Verheyen G,et al.Live birth rate is significantly higher after blastocyst transfer than after cleavage-stage embryo transfer when at least four embryos are available on day 3 of embryo culture.A randomized prospective study[J].Hum Reprod,2005,20:3198-3203.
[15]Magli MC,Jones GM,Gias L,et al.Chromosome mosaicism in day 3aneuploid embryos that develop to morphologically normal blastocysts in vitro[J].Hum Reprod,2000,15:1781-1786.
[16]Papanikolaou EG,Camus M,Fatemi HM,et al.Early pregnancy loss is significantly higher after day 3 single embryo transfer than after day 5single blastocyst transfer in GnRH antagonist stimulated IVF cycles[J/OL].Reprod Biomed Online,2006,12:60-65.
[17]Bhattacharya S,Kamath MS.Reducing multiple births in assisted reproduction technology[J].Best Pract Res Clin Obstet Gynaecol,2014,28:191-199.
[18]McLernon,DJ,Harrild K,Bergh C,et al.Clinical effectiveness of elective single versus double embryo transfer:meta-analysis of individual patient data from randomised trials[J].BMJ,2010.341:c6945.
[19]何巧花,李杭生,张国玲,等.新鲜囊胚与玻璃化冷冻囊胚复融周期移植的临床结局比较[J].生殖医学杂志,2014,10:809-812.
[20]Karlstrm PO,Bergh C.Reducing the number of embryos transferred in Sweden-impact on delivery and multiple birth rates[J].Hum Reprod,2007.22(8):2202-2207.
基本信息:
中图分类号:R714.8
引用信息:
[1]倪晓蓓,王珊珊,张宁媛,等.在OHSS高危患者中卵裂期胚胎移植与囊胚移植的临床结局分析[J].生殖医学杂志,2016,25(07):610-613.
2016-07-15
2016-07-15