【摘要】 目的分析冻融胚胎移植(FET)周期中非优质胚胎的临床结局,探讨非优质胚胎冷冻与移植的价值。方法回顾性分析202个优质胚胎及144个非优质胚胎移植周期的妊娠率、种植率的差异及影响因素,以及非优质胚胎解冻后继续培养的情况。结果与优质胚胎组相比,非优质胚胎组患者年龄[(32.08±4.39)岁vs.(30.48±4.23)岁]、胚胎解冻后培养胚胎未生长比例(26.54%vs.15.52%)显著升高,而形成囊胚的比例(0.62%vs.4.10%)、胚胎种植率(13.66%vs.30.28%)及临床妊娠率(26.67%vs.51.55%)均显著下降,差异均有统计学意义(P<0.05);135个非优质胚胎FET周期共移植胚胎322枚,5B胚胎组解冻后胚胎存活率显著高于4B组(100%vs.91.87%)(P<0.05);与4B胚胎组相比,5B胚胎组未生长胚胎的比例较低(22.86%vs.32.53%),但无统计学差异(P>0.05)。结论年龄是胚胎质量及妊娠结局的重要因素;非优质胚胎中部分胚胎具有继续发育的潜能,对于优质胚胎较少或没有剩余的患者,可考虑冷冻/移植非优质胚胎,其中5B胚胎可能更有价值。更多还原

【Abstract】 Objective:To analyze the clinical value of transferring frozen-thawed non-top quality embryo.Methods:The data of 346frozen-thawed embryo transfer(FET)cycles were analyzed retrospectively.All the cycles were divided into two groups according to the quality of Day-3embryo:top quality embryo group(202cycle)and non-top quality embryo groups(144cycles).The pregnancy and implantation rate and other affecting factors were compared between the two groups.The results of non-top quality embryos after thawed and cultured were observed.Results:The age of the women in the non-top quality embryo group was significantly higher than that of the top quality group [(32.08±4.39)vs.(30.48±4.23)years](P<0.05).The undeveloped embryo rate in the non-top quality embryo group was significantly higher than that of the top embryo group(26.54% vs.15.52%),while the blastocyst formation rate(0.62% vs.4.10%),the implantation rate(13.66% vs.30.28%),and the clinical pregnancy rate(26.67% vs.51.55%)were all significantly lower(P<0.05).In 135 FET cycles of non-top quality embryo,322 embryos were transferred.The survival rate of 5Bembryos after thawing was significantly higher than that of 4Bembryos(100% vs.91.87%)(P<0.05).The undeveloped embryo rate in 5Bembryo group was lower than that in 4Bembryo group(22.86% vs.32.53%),but there was no significant difference(P>0.05).Conclusions:Age is one of risk factors for embryo quality and clinical outcome of assisted reproductive technology.Some non-top quality embryos have potential to develop further.It is worthy to freeze and transfer non-top quality embryos for the patients with few or no high quality embryos,which can improve the cumulative pregnancy rate,especially for 5Bembryos.更多还原