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目的探讨取卵后第4天(D4)桑葚胚或第5天(D5)囊胚移植对行体外受精-胚胎移植(IVF-ET)患者妊娠结局的影响。方法回顾性分析2016年1月至2016年12月在北京妇产医院生殖科行IVF-ET的182个周期的临床资料,分为D4桑葚胚移植组(102例)和D5囊胚移植组(80例),比较两组平均移植胚胎数、临床妊娠率、种植率、活产率、异位妊娠率及足月分娩率等。结果 D4桑葚胚移植组与D5囊胚移植组比较,平均移植胚胎数[(1.80±0.32)vs.(1.79±0.28)]、临床妊娠率(45.09%vs.48.75%)、种植率(34.52%vs.35.33%)、活产率(36.27%vs.41.25%)及足月分娩率(86.48%vs.81.82%)均无显著差异(P均>0.05)。结论 D4桑葚胚移植与D5囊胚移植的妊娠结局大体相当,可以作为不便行囊胚培养患者的另一种可行性选择。
Abstract：Objective:To investigate whether the day of embryo transfer(Day 4 or Day 5)affects clinical pregnancy outcomes in IVF-ET cycles.Methods:The data of 1 8 2 IVF-ET cycles in our centre from January 2 0 1 6 to December 2 0 1 6 were retrospectively analyzed.The cycles were divided into Day 4 transfer group(n=1 0 2)and Day 5 transfer group(n= 8 0).The average number of transplanted embryos,clinical pregnancy rate,implantation rate,live birth rate,ectopic pregnancy rate and full-term delivery rate were compared between the two groups.Results:There were no significant difference in average number of transplanted embryos[(1.80±0.32)vs.(1.79±0.28)],clinical pregnancy rate(45.09% vs.48.75%),implantation rate(34.52%vs.35.33%),live birth rate(36.27% vs.41.25%)and term birth rate(86.48% vs.81.82%)(P>0.05).Conclusions:Day 4 transplantation has no significant effect on IVF-ET pregnancy outcome.It can be another viable option for patients with inconvenience for blastocyst culture.
[1]Balaban B,Yakin K,Alatas C,et al.Clinical outcome of intracytoplasmic injection of spermatozoa morphologically selected under high magnification:aprospective randomized study[J/OL].Reprod Biomed Online,2011,22:472-476.
[2]Tao J,Tamis R,Fink K.Pregnancies achieved after transferring frozen morula/compact stage embryos[J].Fertil Steril,2001,75:629-631.
[3]Schoolcraft WB,Gardner DK,Lane M,et al.Blastocyst culture and transfer:analysis of results and parameters affecting outcome in two in vitro fertilization programs[J].Fertil Steril,1999,72:604-609.
[4]Jones GM,Trounson AO,Gardner DK,et al.Evolution of a culture protocol for successful blastocyst development and pregnancy[J].Hum Reprod,1998,13:169-177.
[5]Milki AA,Hinckley MD,Fisch JD,et al.Comparison of blastocyst transfer with day 3 embryo transfer in similar patient populations[J].Fertil Steril,2000,73:126-129.
[6]Montag M,van der Ven K,Dorn C,et al.Extended embryo culture reduces the implantation rate on day 4and day 5 when only a maximum of three embryos are cultured beyond the pronuclear stage[J].Eur J Obstet Gynecol Reprod Biol,2006,124:65-69.
[7]Tao J,Tamis R,Fink K,et al.The neglected morula/compact stage embryo transfer[J].Hum Reprod,2002,17:1513-1518.
[8]Braude P,Bolton V,Moore S.Human gene expression first occurs between the four-and eight-cell stages of preimplantation development[J].Nature,1988,332:459-461.
[9]Hsieh CE,Lee RK,Sun FJ,et al.Early blastulation(EB)of day 4embryo is predictive of outcomes in single embryo transfer(SET)cycles.[J].Taiwan J Obstet Gynecol.2018,57:705-708.
[10]Maheshwari A,Hamilton M,Bhattacharya S.Should we be promoting embryo transfer at blastocyst stage?[J/OL].Reprod Biomed Online,2016,32:142-146.
[11]Fabozzi G,Alteri A,Rega E,et al.Morphological assessment on day 4and its prognostic power in selecting viable embryos for transfer[J].Zygote,2016,24:477-484.
[12]Vassena R,BouéS,González-Roca E,et al.Waves of early transcriptional activation and pluripotency program initiation during human preimplantation development[J].Development,2011,138:3699-3709.
[13]Feil D,Henshaw RC,Lane M.Day 4embryo selection is equal to Day 5using a new embryo scoring system validated in single embryo transfers[J].Hum Reprod,2008,23:1505-1510.
[14]Li RS,Hwu YM,Lee RK,et al.Day 4good morula embryo transfer provided compatible live birth rate with day 5blastocyst embryo in fresh IVF/ET cycles[J].Taiwan JObstet Gynecol,2018,57:52-57.
[15]Lee SH,Lee HS,Lim CK,et al.Comparison of the clinical outcomes of day 4and 5embryo transfer cycles[J].Clin Exp Reprod Med,2013,40:122-125.
[16]Holschbach V,Weigert J,Dietrich JE,et al.Pregnancy rates of day 4and day 5embryos after culture in an integrated timelapse incubator[J].Reprod Biol Endocrinol,2017,15:37.
[17]Glujovsky D,Farquhar C,Quinteiro Retamar AM,et al.Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology[DB/OL].Cochrane Database Syst Rev,2016,(30):CD002118.
[18]徐蓓,靳镭.现阶段中国实行选择性单胚胎移植的时机是否成熟[J].生殖医学杂志,2018,27:879-883.
基本信息:
中图分类号:R714.8
引用信息:
[1]辛志敏,杨晓葵,余兰,等.取卵后第四天或第五天移植对体外受精-胚胎移植妊娠结局的影响[J].生殖医学杂志,2019,28(08):886-889.
2019-08-14
2019-08-14