Li Mingzhao, Wang Hui, Ma Chun, Shi Juanzi
a The ART Center, Northwest Women's and Children's Hospital , Xi'an , China.
Gynecol Endocrinol. 2017 Jul;33(7):557-559. doi: 10.1080/09513590.2017.1302420. Epub 2017 Mar 28.
The aim of this study was to explore whether transferring two grades I cleavage-stage embryo was suitable for the patients in the first fresh transfer.
This study included 202 single grades I cleavage-stage, 229 single grades III cleavage-stage, 743 single excellent blastocyst, 522 double grades I cleavage-stage, and 596 double grades III cleavage-stage embryo transfers. Main clinical outcomes: clinical pregnancy and twin-pregnancy rate.
Among single excellent blastocyst, single grades I and single grades III group, the clinical pregnancy rate was significantly higher in single excellent blastocyst group than single grades I and grades III group (67.16% versus 42.08% versus 23.97%; p < 0.001). When transferred double grades I cleavage-stage embryos, the clinical pregnancy rate reached 68.20% which was no significant difference compared with the single excellent blastocyst group (67.16%). However, the twin-pregnancy rate was significantly higher in double grades I group than double grades III and single excellent blastocyst group (43.26% versus 26.70% versus 0.60%; p < 0.001).
Because of higher twin-pregnancy incidence rate, transferring two grades I cleavage-stage embryo might not be a good protocol. Extended culture to blastocyst-stage could be considered for the patient with only two grades I cleavage-stage embryos.
本研究旨在探讨首次新鲜移植时移植两枚I级卵裂期胚胎是否适合患者。
本研究纳入了202例单枚I级卵裂期胚胎移植、229例单枚III级卵裂期胚胎移植、743例单枚优质囊胚移植、522例双枚I级卵裂期胚胎移植和596例双枚III级卵裂期胚胎移植。主要临床结局：临床妊娠率和双胎妊娠率。
在单枚优质囊胚组、单枚I级组和单枚III级组中，单枚优质囊胚组的临床妊娠率显著高于单枚I级组和III级组（67.16%对42.08%对23.97%；p<0.001）。移植双枚I级卵裂期胚胎时，临床妊娠率达到68.20%，与单枚优质囊胚组（67.16%）相比无显著差异。然而，双枚I级组的双胎妊娠率显著高于双枚III级组和单枚优质囊胚组（43.26%对26.70%对0.60%；p<0.001）。
由于双胎妊娠发生率较高，移植两枚I级卵裂期胚胎可能不是一个好方案。对于仅有两枚I级卵裂期胚胎的患者，可考虑延长培养至囊胚期。
