囊胚期胚胎培养与移植的临床研究

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目的:研究囊胚期胚胎培养与移植对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法:将行常规IVF-ET助孕的80个周期,常规取卵、受精后随机分为卵裂期胚胎移植和囊胚期胚胎移植两组,每组各40例,卵裂期胚胎移植组第2天或第3天进行胚胎移植,囊胚期胚胎移植组采用Quinn’s培养基序贯培养,第5天或第6天行至少1个3期以上囊胚移植,比较两组获卵数、受精率、卵裂率、平均胚胎植入数及妊娠率的差异。结果:两组获卵数和受精率无明显差异;两组平均胚胎植入数分别为(2.43±0.54)枚和(1.52±0.47)枚、生化妊娠率分别为60.0%和47.5%、临床妊娠率分别为52.5%和30.0%,平均移植胚胎数和妊娠率两组比较均有显著性差异(P<0.05)。结论:囊胚期胚胎移植组移植较少的胚胎即可获得较高的妊娠率,采用囊胚期胚胎移植可明显提高IVF-ET妊娠率,并可降低胚胎植入数,从而减少多胎率的发生。 Objective: To study the effect of blastocyst stage embryo culture and transplantation on the pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods: Eighty cycles of conventional IVF-ET assisted pregnancy were routinely oviducted. After fertilization, they were randomly divided into two groups: cleavage stage embryo transfer and blastocyst stage embryo transfer, 40 cases in each group, Day 2 or day 3 embryo transfer, blastocyst embryo transfer group using sequential culture of Quinn’s medium, the first 5 days or 6 days at least one more than 3 blastocysts transplantation, the number of oocytes in both groups were compared, Fertilization rate, cleavage rate, the average number of embryo implantation and pregnancy rate differences. Results: The average number of embryos implanted in the two groups was (2.43 ± 0.54) and (1.52 ± 0.47), respectively. The biochemical pregnancy rates were 60.0% and 47.5%, respectively. Clinical pregnancy Rates were 52.5% and 30.0%, respectively. There was a significant difference between the average number of embryos transferred and the pregnancy rate (P <0.05). CONCLUSIONS: Blastocyst-derived embryo transplantation can achieve a higher pregnancy rate with fewer embryos transplanted, and the blastocyst stage embryo transfer can significantly improve the pregnancy rate of IVF-ET and reduce the number of embryo implantation, thus reducing the multiple birth rate occur.
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