| 傅 悦,徐 源,柏明珠,孙 翟,张箴波.极严重少弱精症患者的新鲜周期移植中卵裂球数目对妊娠结局的影响[J].,2020,(17):3207-3211 |
| 极严重少弱精症患者的新鲜周期移植中卵裂球数目对妊娠结局的影响 |
| Effect of Blastomere Number in Fresh Cycles on Pregnancy Outcomes in Patients with Severe Oligozoospermia |
| 投稿时间：2020-02-27 修订日期：2020-03-23 |
| DOI：10.13241/j.cnki.pmb.2020.17.002 |
| 中文关键词: 卵裂球数 新鲜胚胎移植 极严重少弱精症 胚胎评级 妊娠结局 |
| 英文关键词: Number of Blastomeres Fresh embryo transfer Severe oligospermia Embryo grade Reproductive outcome |
| 基金项目:上海交通大学医工交叉基金项目（YG2016MS27） |
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| 中文摘要: |
| 摘要 目的：探讨极严重少弱精症患者的新鲜周期移植中卵裂球数目对妊娠结局的影响。方法：回顾性分析392个新鲜胚胎移植周期，这些胚胎根据移植天数分为第二天移植（Day2）组68周期和第三天移植（Day3）组324周期，其中Day2组根据卵裂球数分为<3个（A组，3周期），3～5个（B组，57周期），>5个（C组，8周期），Day3组根据卵裂球数分为<7个（D组，33周期），7～9个（E组，242周期），>9个（F组，49周期）。每个组又根据胚胎评级分为三个亚组，亚组1均为移植1～2级的胚胎（A1～F1），亚组2均为移植3～4级的胚胎（A2～F2），亚组3为一个1～2级和一个3～4级移植胚胎(A3～F3)。综合比较各组和相应亚组之间的种植率，临床妊娠率，流产率及活产率的差别。结果：①在day2组中，ABC三组的胚胎种植率，临床妊娠率，流产率及活产率均无统计学差异（P>0.05）。在Day3组中， E组的胚胎种植率，临床妊娠率及活产率均高于D组，差异具有统计学意义（P<0.05）。而D组和F组及E组和F组之间差异均无统计学意义。②在相同卵裂球数组中，不同的胚胎分级各亚组之间（如B1,B2,B3间）的胚胎种植率，临床妊娠率，流产率及活产率均无统计学差异。不同卵裂球数其相应的同一亚组之间（A1,B1,C1等）上述妊娠结局指标无统计学差异。结论：严重少弱精形成的胚胎优先推荐第二天卵裂球数为3~5个及第三天卵裂球数为7~9个的优质胚胎进行移植。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of the number of blastomeres in fresh embryos transfer on the outcome of pregnancy in patients with severe oligospermia. Methods: A retrospective analysis was performed of data from 392 patients who received fresh embryos transfer. According to the days of transplantation, these embryos were divided into 68 cycles of day2 transfer (group Day2) and 324 cycles of day3 transfer (group Day3). Then according to the number of blastomeres group Day2 was divided into 3 cycles of <3-cell group(group A), 57 cycles of 3~5-cell group(group B) and 8 cycles of >5-cell group(group C) , group Day3 was divided into 33 cycles of <7-cell group(group D), 242 cycles of 7~9-cell group(group E) and 49 cycles of >9-cell group(group F). Each group can be divided into three sub-groups according to the embryo grades. Embryos in sub-group1 all belonged to grade1~2(A1~F1), sub-group2 had embryos which all ranked 3~4grade(A2~F2) and sub-group3 had one 1~2 and one 3~4 grade embryo(A3~F3). The implantation rate, clinical pregnancy rate, miscarriage rate and live birth rate were compared between the groups and corresponding sub-groups respectively. Results: ①There were no significant difference in implantation rate, clinical pregnancy rate, miscarriage rate and live birth rate among the ABC groups in group Day2(P>0.05). While in group Day3, the implantation rate, clinical pregnancy rate, live birth rate of group E were higher than group D, and the differences were statistically significant(P<0.05). But there were no significant differences between groups D and F, and between groups E and F. ②There were no significant differences in implantation rate, clinical pregnancy rate, miscarriage rate and live birth rate between different subgroups of different embryo grades within the same group of blastomere number (such as B1, B2, B3). Embryos in same sub-group but different groups of blastomere number had no significant differences in the pregnancy outcomes mentioned above (such as A1, B1, C1). Conclusion: In fresh cycle transfer of patients with severe asthenozoospermia, high quality embryos with 3~5-cell on day2 and embryos with 7~9-cell on day3 are preferentially recommended to transfer. |
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