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[患者年龄及移植优质胚胎数量对体外受精-胚胎移植中多胎妊娠的影响]

[Influence of patient age and the number of good-quality-embryos transferred on multiple gestation in in vitro fertilization and embryo transfer].

作者信息

Zhang Shun-Ji, Gong Fei, Lin Ge, Lu Chang-Fu, Xiao Hong-Mei, Lu Guang-Xiu

机构信息

Institute of Reproduction and Stem Cell Engineering Center, Central South University, Changsha 410078, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2008 Aug;43(8):567-70.

Abstract

OBJECTIVE

To observe the influence of patient's age, and the number of transferred-good-quality-embryos on multiple gestation rates in in vitro fertilization and embryo transfer (IVF-ET) cycles.

METHODS

In this retrospective study, a total of 4,395 patients who transferred fresh embryo between Jan 2004 and Nov 2006 was analyzed. According to the age, the patients were divided into 2 groups: aged < 35 (3,442 cycles) or aged >or= 35 (953 cycles). We regularly transferred 2 - 3 embryos. If the patients had only one embryo, one was transferred. And those patients who had only 2 embryos, even if they were more than 35 years old or it would be the second time for them to transfer, were transferred 2 embryos. The influence of female age and the number of good quality embryos transferred on the multiple gestation rates in IVF-ET cycle was analyzed.

RESULTS

(1) The multiple gestation rate of the groups of 1 good quality embryo, 2 good quality embryos, or 3 good quality embryos transferred were 21.08% (35/166), 31.41% (413/1315), and 42.37% (75/177), respectively in women aged < 35, with a significant difference between them. The pregnancy rates of these groups were 29.64% (166/560), 51.63% (1,315/2,547), and 52.84% (177/335), respectively; there were no significant differences between 2 good quality embryos transferred group and 3 good quality embryos transferred group. (2) The multiple gestation rates of the groups of 1 good quality embryo, 2 good quality embryos, or 3 good quality embryos transferred were 19.51% (8/41), 20.65% (19/92), and 40.66% (74/182), respectively, in women aged >or= 35; there were no significant differences between 1 good quality embryo transferred group and 2 good quality embryos transferred group. The pregnancy rates of these groups were 19.07% (41/215), 33.70% (92/273), and 39.14% (182/465), respectively; there were no significant differences between 2 good quality embryos transferred group and 3 good quality embryos transferred group. (3) The pregnancy rate of the patients aged < 35 [48.17% (1,658/3,442)] was significantly higher than in women aged >or= 35 [33.05% (315/953)].

CONCLUSION

The transfer of 2 good quality embryos results in similar pregnancy rates and significantly reduced multiple gestation rates when compared to the transfer of 3 good quality embryos in women regardless of their ages.

摘要

目的

观察患者年龄及优质胚胎移植数量对体外受精 - 胚胎移植(IVF - ET)周期多胎妊娠率的影响。

方法

本回顾性研究分析了2004年1月至2006年11月期间共4395例进行新鲜胚胎移植的患者。根据年龄将患者分为2组:年龄<35岁(3442个周期)和年龄≥35岁(953个周期)。常规移植2 - 3个胚胎。若患者仅有1个胚胎,则移植1个。对于仅有2个胚胎的患者,即使年龄超过35岁或为再次移植,也移植2个胚胎。分析女性年龄及优质胚胎移植数量对IVF - ET周期多胎妊娠率的影响。

结果

(1)年龄<35岁的女性中,移植1个优质胚胎、2个优质胚胎、3个优质胚胎组的多胎妊娠率分别为21.08%(35/166)、31.41%(413/1315)和42.37%(75/177),组间差异有统计学意义。这些组的妊娠率分别为29.64%(166/560)、51.63%(1315/2547)和52.84%(177/335);移植2个优质胚胎组和移植3个优质胚胎组之间无显著差异。(2)年龄≥35岁的女性中,移植1个优质胚胎、2个优质胚胎、3个优质胚胎组的多胎妊娠率分别为19.51%(8/41)、20.65%(19/92)和40.66%(74/182);移植1个优质胚胎组和移植2个优质胚胎组之间无显著差异。这些组的妊娠率分别为19.07%(41/215)、33.70%(92/273)和39.14%(182/465);移植2个优质胚胎组和移植3个优质胚胎组之间无显著差异。(3)年龄<35岁患者的妊娠率[48.17%(1658/3442)]显著高于年龄≥35岁的女性[33.05%(315/953)]。

结论

无论年龄大小,与移植3个优质胚胎相比,移植2个优质胚胎可使妊娠率相似且多胎妊娠率显著降低。

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