选择性卵裂期单胚胎移植的妊娠分娩结局.PDFVIP

·512 · doi 10.3969/j.issn. 1673-4254.2017.04.15 J South Med Univ, 2017, 37(4): 512-516 临床研究 选择性卵裂选择性卵裂期单胚胎移植的妊娠分娩结局期单胚胎移植的妊娠分娩结局 孙 玲，陈志恒，尹敏娜，邓 宇，刘 俊 广州市妇女儿童医疗中心生殖医学中心，广东 广州 510623 摘要：目的 比较选择性卵裂期单个优质胚胎移植与双优质胚胎移植的妊娠分娩结局。方法 回顾性分析2014 年1月~2015 年 10月在广州市妇女儿童医疗中心生殖医学中心实施体外受精胚胎移植治疗年轻患者239 例，选择单个卵裂期优质胚胎进行移 植的年轻患者39 例为研究组，同期移植2 个优质胚胎的年轻患者200 例对照组。分析比较两组间临床妊娠结局及分娩结局。 结果 两组平均年龄、体质量指数、基础内分泌、不孕年限、HCG 日子宫内膜厚度无统计学差异（P0.05）；单胚胎移植组HCG 日 雌激素水平、获卵数高于双胚胎移植组，总Gn 用量低于双胚胎移植组（P0.05）；单胚胎移植组胚胎着床率为56.4% ，高于双胚胎 移植组的37.8%（P0.05）；两组临床妊娠率和活产率无统计学差异（56.4% vs 66.0% ，48.7% vs 51.5% ，P0.05）。单胚胎移植组 无1例多胎妊娠，而双胚胎移植组双胎妊娠率为22.7%（P0.05）。单胚胎移植组分娩孕周、新生儿出生体质量明显高于双胚胎 移植组（38.7 周vs 37.8 周，3.3 kg vs 2.9 kg ，P0.05）；早产率在单胚胎组仅为10.5% ，低于双胚胎移植组27.2% ，但差异无显著 性。单胚胎移植组无1例低体质量儿出生，而双胎组低体质量儿比例占22.6%（P0.05）。结论 卵裂期选择性单胚胎移植与双 胚胎移植相比，可明显降低双胎率，对活产率无影响，同时可以获得更好的产科结局。 关键词：选择性单胚胎移植；多胎率；妊娠结局；产科结局 Pregnancy and obstetric outcomes of elective single versus double cleavage-stage embryo transfer SUN Ling, CHEN Zhiheng, YIN Minna, DENG Yu, LIU Jun Assisted Reproductive Medical Center, Guangzhou Women and Childrens Hospital, Guangzhou 510623, China Abstract: Objective To compare the pregnancy and obstetric outcomes in elective single versus two cleavage-stage embryo transfer. Methods Fresh cleavage-stage embryo transfer cycles between January, 2014 and October, 2015 were reviewed, including 39 single embryo transfer (eSET) cycles and 200 double embryo transfer (DET) cycles. The clinical pregnancy rates, implantation rates, multiple pregnancy rates, live birth rate, and obstetric outcomes (gestational age, preterm delivery rate and mean birth weight) were compared between the two groups. Results The baseline characteristics were comparable between the two groups. The estradiol level on the day of trigger and the oocyte number were significantly higher in eSET group than in DET g