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目的探讨选择性单胚胎移植、选择性单囊胚移植对行体外受精-胚胎移植者妊娠结局的影响。方法 860例行体外受精-胚胎移植不孕患者,其中260例行选择性单胚胎移植(eSET组),400例行选择性单囊胚移植(eSBT组),200例行双胚胎移植(DBT组),回顾性分析3组临床资料,比较其妊娠率及妊娠结局的差异。结果 3组年龄、基础卵泡刺激素及黄体生成素水平、子宫内膜厚度、促性腺激素用量及使用时间、获卵数、正常受精率、两原核率、胚胎形成率和流产率比较差异无统计学意义(P>0.05);eSET组临床妊娠率为32.31%,多胎妊娠率为3.08%,早产率为11.92%,低体质量儿出生率为12.31%;eSBT组以上指标分别为54.00%、2.00%、12.00%、10.00%;DBT组分别为56.50%、32.50%、29.50%、37.00%,eSET组临床妊娠率低于eSBT组和DBT组(P<0.05),DBT组多胎妊娠率、早产率、低体质量儿出生率高于eSET组和eSBT组(P<0.05)。结论与双胚胎移植相比,选择性单胚胎移植和选择性单囊胚移植可明显降低多胎妊娠率、早产率和低体质量儿出生率。
Objective To investigate the effect of selective single embryo transfer and selective single blastocyst transplantation on pregnancy outcomes in IVF-ET. Methods Eighty - six patients with infertility undergoing in vitro fertilization - embryo transfer were enrolled. Among them, 260 patients underwent elective single embryo transfer (eSET), 400 patients underwent elective single blastocyst transplantation (eSBT) and 200 underwent double embryo transfer (DBT) ), Three groups of clinical data were retrospectively analyzed to compare the difference of pregnancy rate and pregnancy outcome. Results There were no significant differences in age, basic follicle stimulating hormone and luteinizing hormone level, endometrial thickness, gonadotropin dosage, time of use, number of oocytes retrieved, normal fertilization rate, prokaryotic rate, embryo formation rate and miscarriage rate (P> 0.05). The clinical pregnancy rate in eSET group was 32.31%, the multiple pregnancy rate was 3.08%, the premature delivery rate was 11.92%, the birth rate in low birth weight children was 12.31%, while the eSET group was 54.00%, 2.00% , 12.00% and 10.00% in the DBT group, and 56.50%, 32.50%, 29.50% and 37.00% in the DBT group respectively. The clinical pregnancy rates in the eSET group were lower than those in the eSET group and DBT group (P <0.05) The birth rate of low birth weight children was higher than that of eSET group and eSBT group (P <0.05). Conclusion Compared with double embryo transfer, selective single embryo transfer and selective single blastocyst transplantation can significantly reduce the rate of multiple pregnancy, premature birth and low birth weight.