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目的:探讨既往自然流产次数与患者第3日胚胎质量的关系。方法:回顾性分析因单纯输卵管因素或盆腔粘连原因行第1周期体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)治疗的患者资料,排除已知的影响流产和胚胎发育疾病的患者,将患者按流产次数分为4组,分别为既往自然流产次数0次组(n=1 252)、1次组(n=385)、2次组(n=77)和≥3次组(n=36)。结果:第3日的优质胚胎率和受精率各组间比较均有统计学差异(P<0.05);既往自然流产0次、1次、2次组的优质胚胎率随流产次数增加呈下降趋势(P=0.005);但既往自然流产≥3次组的优质胚胎率和受精率较2次自然流产组均有升高趋势,进一步分析患者临床资料显示,既往自然流产≥3次的患者在IVF-ET前进行全面的自然流产原因筛查和治疗的比例显著高于2次自然流产组,差异具有统计学意义(P=0.011)。结论:既往2次自然流产患者的胚胎质量下降;经系统、全面的自然流产原因筛查,并接受相应治疗后再行IVF-ET,自然流产次数≥3次的患者其受精率和优质胚胎率可有所提高。
Objective: To investigate the relationship between the number of past spontaneous abortion and the quality of embryo on the third day in patients. Methods: The data of patients treated with IVF-ET in the first cycle due to simple fallopian tube or pelvic adhesions were retrospectively analyzed, and the known causes of abortion and embryo development were excluded Patients were divided into 4 groups according to the number of abortions: 0 times of past spontaneous abortion (n = 1 252), 1 time (n = 385), 2 times (n = 77) and 3 times (n = 36). Results: On the third day, the quality embryo rate and fertilization rate were significantly different among the groups (P <0.05). The rate of high-quality embryos of 0, 1, 2 groups in the previous spontaneous abortion decreased with the increase of the number of abortion (P = 0.005). However, the rate of high-quality embryos and fertilization in the third and third groups of spontaneous abortion tended to increase compared with the second spontaneous abortion group. Further analysis of the clinical data showed that the patients with previous natural abortion ≥3 times had higher IVF The proportion of patients who had a full-scale spontaneous abortion screening and treatment before ET was significantly higher than that of 2 spontaneous abortions (P = 0.011). CONCLUSIONS: The quality of embryos in the first two spontaneous abortions declines. The screening rate of IVF-ET and spontaneous abortion more than or equal to 3 times after screening by reason of systematic and comprehensive spontaneous abortion and the rate of high-quality embryos Can be improved.