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目的探讨体外受精-胚胎移植卵巢高反应患者行囊胚移植的妊娠结局和应用价值。方法回顾性分析2016年5月至2017年2月在我院生殖中心进行体外受精-胚胎移植(IVF-ET)治疗的不孕患者资料,卵巢过度刺激综合征(OHSS)高风险患者行双卵裂胚移植84个周期(A组),行普通单囊胚移植58个周期(非优质囊胚),行单优质囊胚移植40个周期,比较三组患者常规临床特征、超促排卵情况、胚胎发育质量、临床妊娠率、种植率、多胎率、中重OHSS发生率。结果三组不孕患者体重指数、基础FSH、Gn使用量、Gn使用时间、HCG注射日E2/P水平、获卵数、受精率、卵裂率等相互比较均无统计学意义(P>0.05)。单优质囊胚组的妊娠率显著高于双卵裂胚移植组和单囊胚移植组(P<0.05)。双卵裂胚移植组的种植率显著低于单囊胚移植组和单优质囊胚组(P<0.05),同时双卵裂胚移植组的多胎率显著高于其他两组(P<0.01)。双卵裂胚移植组的中重度OHSS发生率为10.67%,高于其他两组,差异具有统计学意义(P<0.05)。结论卵巢过度刺激综合征高风险患者行单囊胚移植可以减小0HSS及多胎妊娠的发生,且不影响临床妊娠率。
Objective To investigate the pregnancy outcome and the value of blastocyst transplantation in patients with high ovarian response to in vitro fertilization and embryo transfer. Methods The data of infertility patients who underwent in vitro fertilization and embryo transfer (IVF-ET) from May 2016 to February 2017 in our hospital were retrospectively analyzed. The patients with high risk of ovarian hyperstimulation syndrome (OHSS) Eighty cycles (group A) of single embryo transfer and 58 cycles of normal single blastocyst (non-high quality blastocyst) were performed, and 40 cycles of single blastocyst transplantation were performed. The clinical features, superoxidation, Embryo developmental quality, clinical pregnancy rate, implantation rate, multiple birth rate, moderate and severe OHSS incidence. Results The body mass index, basic FSH, Gn usage, Gn use time, E2 / P level on the day of HCG injection, number of oocytes retrieved, fertilization rate and cleavage rate were not significantly different among the three groups (P> 0.05 ). The pregnancy rate of single blastocyst group was significantly higher than that of double blastocyst transplantation group and single blastocyst transplantation group (P <0.05). The implantation rate in the double cleavage embryo transfer group was significantly lower than that in the single blastocyst group and the single blastocyst group (P <0.05), while the multiple birth rate in the double cleavage embryo transfer group was significantly higher than that in the other two groups (P <0.01) . The incidence of moderate-severe OHSS in the double-cleaved embryo transfer group was 10.67%, which was higher than the other two groups (P <0.05). Conclusions Single blastocyst transplantation can reduce the incidence of 0HSS and multiple pregnancy in patients with high risk of ovarian hyperstimulation syndrome without affecting the clinical pregnancy rate.