摘要
目的:探讨移植胚胎数目对高龄不孕患者IVF-ET结局的影响。方法:根据移植胚胎个数将年龄超过35岁的不孕患者338个周期分为单胚胎移植组(Ⅰ组),2个胚胎移植组(Ⅱ组),3个胚胎移植组(Ⅲ组)。分析患者IVF治疗情况并按年龄分层比较三组患者的IVF-ET结局。结果:高龄不孕患者行IVF,随年龄增加,获卵数、优质胚胎率和临床妊娠率降低,流产率呈增高趋势。Ⅰ组的妊娠率9.43%,显著低于Ⅱ组(24.24%)和Ⅲ组(31.37%)(P<0.05)。对于40岁以下的患者,移植3个胚胎的妊娠率与移植2个胚胎差无异,但显著高于移植1个胚胎(P<0.05)。增加40岁以上患者移植胚胎的数目,妊娠率未出现有统计学意义的升高。三组的胚胎种植率分别为9.43%,12.12%和12.2%,无统计学差异。Ⅲ组中多胎率12.5%(6/48),其中35～36岁年龄段多胎率16.67%(5/30)。结论:高龄不孕患者可移植的胚胎数目随年龄增加和获卵数目降低而降低。其中较年轻者(35～36岁年龄段),移植3个胚胎,对妊娠率提高无明显效果,但多胎发生显著增加。
Objective： To investigate whether the number of transferred embryo would influence the pregnancy outcomes of aged infertile patients undergoing IVF-ET. Methods： Infertile patients aged above 35 yrs （289 patients, 338 cycles） were included in this study. They were divided into three groups according to the number of transferred embryo： Group Ⅰ , single embryo transferred; Group Ⅱ, double embryos transferred; Group Ⅲ, three embryos transferred. Groups were compared in terms of pregnancy rate, implantation rate, mul- tiple pregnancy rate, and reproductive outcomes were analyzed according to age group. Results： The pregnancy rate, as well as the number of oocytes retrieved and embryos of good quality, decreased with age. The abortion rate increased with age. The pregnancy rate in Group Ⅰ （9.43%） was significantly lower than that in Group （24.24%） and Group Ⅲ （31.37%）（P〈0.05）. In patients aged below 40yrs, there was no significant difference in pregnancy rate when comparing three-embryo transfer with double-embryo transfer, but both were significantly higher than that of single embryo transfer （P〈0.05）. In patients aged above 40yrs, increasing the number of embryo trans- ferred did not lead to statistically significant increase in pregnancy rate. The implantation rate was comparable in three groups （9.43%, 12.12% and 12.2% respectively）. In Group Ⅲ, the multiple pregnancy rate was 12.5% （4 twin and 2 triplet pregnancy, 6/48）, in the 35-36 yrs age group, the multiple pregnancy rate was as high as 16.67% （5/30）. Conclusions： The number of embryo of good quality for transfer decreased with the advancing of age and decreasing of retrieved oocytes number. Transfer of 3 embryos in the younger patients （aged 35-36 yrs） could not increase the pregnancy rate obviously but cause high incidence of multiple pregnancy significantly.
出处
《现代生物医学进展》
CAS
2009年第5期835-837,共3页
Progress in Modern Biomedicine
基金
四川大学青年科学基金(02014)资助
