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目的:探讨冻融胚胎移植(FET)周期中胚胎卵裂球损伤是否作为独立的因素影响妊娠结局的发生。方法:回顾性分析2008年1月～2008年11月在华中科技大学同济医学院附属同济医院生殖医学中心进行FET的患者病历,根据复苏后移植胚胎的卵裂球的完整与否分为两组:复苏后移植胚胎的卵裂球均完整组287例,移植胚胎的卵裂球均有部分损伤组51例。应用logistic回归的方法分析了冻融后胚胎卵裂球损伤及胚胎质量与临床妊娠率的关系。结果:FET胚胎卵裂球完整组与卵裂球损伤组在女性年龄,平均每周期移植胚胎个数上比较无统计学差异(P>0.05);卵裂球完整组的临床妊娠率和胚胎种植率均高于卵裂球损伤组(36.2%vs 21.6%,22.3%vs 13.4%),两组比较有统计学差异(P<0.05);但卵裂球完整组移植的胚胎中含有优质胚胎的周期比例数要多于卵裂球损伤组(74.9%vs 58.8%,P<0.05),经logistic回归分析,平衡了优质胚胎的影响后,卵裂球损伤与临床妊娠率之间无显著性关系(P>0.01)。结论:冻融胚胎卵裂球损伤与临床妊娠率之间无明显相关性,胚胎质量是影响临床结局的关键性因素。
Objective: To investigate whether embryo blastomere injury in frozen-thawed embryo transfer (FET) cycle affects the outcome of pregnancy as an independent factor. Methods: A retrospective analysis of patients’ medical history of FET performed at Reproductive Medicine Center, Tongji Medical College Affiliated Tongji Medical College, Huazhong University of Science and Technology from January 2008 to November 2008 was divided into two groups according to the integrity of the blastocysts of the embryos after resuscitation : After the resuscitation, the blastocysts of the transplanted embryos were all intact (287 cases), and the blastomeres of the transplanted embryos were partially damaged (51 cases). Logistic regression method was used to analyze the relationship between embryonic blastomere damage and embryo quality and clinical pregnancy rate. Results: There was no significant difference in the number of female embryos and blastomere injury between embryonic blastomere group and blastomere injury group (P> 0.05). The clinical pregnancy rate and embryo implantation rate (36.2% vs 21.6%, 22.3% vs 13.4%, respectively). There was a significant difference between the two groups (P <0.05). However, the embryos of blastomere transplantation group contained high quality embryos The proportion of cycles was higher than that of blastomere damage group (74.9% vs 58.8%, P <0.05) .By logistic regression analysis, there was no significant relationship between blastomere damage and clinical pregnancy rate after balancing the influence of high quality embryo (P> 0.01). Conclusion: There is no significant correlation between the blastocyst damage of frozen-thawed embryo and the clinical pregnancy rate, and embryo quality is the key factor affecting the clinical outcome.