Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2020 Oct;40(5):968-972. doi: 10.1007/s11596-020-2254-5. Epub 2020 Oct 29.
This study compared the clinical outcomes of the frozen-thawed cycles of high-quality cleavage embryos with low-quality blastocysts to provide a reference for the choice of frozen-thawed embryo transfer schemes and to improve clinical pregnancy rates. A retrospective analysis was performed on the clinical data of patients undergoing frozen-thawed embryo transfer at the Reproductive Medicine Center of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from 2016 to 2017. In total, 845 cases were divided into a high-quality cleavage embryo group (group A) and a low-quality blastocyst group (group B). Each group was further divided into subgroups based on the number of transplants. Group A was categorized into two subgroups comprising of 94 cases in subgroup A1 (1 high-quality 8-cell group) and 201 cases in subgroup A2 (2 high-quality 8-cell group). Group B was divided into four subgroups consisting of 73 cases in subgroup B1 (D53BC group), 65 cases in subgroup B2 (D54BC group), 110 cases in subgroup B3 (D63BC group), and 282 cases in subgroup B4 (D64BC group). The pregnancy outcomes and neonatal outcomes between the groups were compared. The clinical pregnancy rates (56.72% and 60.00%) and live birth rates (47.76% and 46.15%) in subgroups A2 and B2 showed no significant differences, but these rates were significantly higher in subgroups A2 and B2 than in the rest subgroups (P<0.05). The multiple birth rate (26.32%) in the subgroup A2 was significantly higher than that in the rest subgroups (P<0.05). There were no statistically significant differences in the abortion rates among all groups (P>0.05). In terms of neonatal outcomes, there were no statistically significant differences in the proportion of premature births, sex ratios, and birth defects among the low-weight and gigantic infants (P>0.05). Transplanting two high-quality cleavage embryos during the frozen-thawed embryo transfer cycles could significantly increase clinical pregnancy rates and live birth rates, but at the same time, it also increased the risks of multiple births and complications to mothers and infants. The D54BC subgroup had the most significant advantages among all groups (P<0.05). The rest low-quality blastocysts had clinical outcomes similar to the single high-quality cleavage embryo group.
本研究比较了优质卵裂胚胎与低质量囊胚的冷冻-解冻周期的临床结局，为冷冻-解冻胚胎移植方案的选择提供参考，以提高临床妊娠率。对 2016 年至 2017 年华中科技大学同济医学院同济医院生殖医学中心进行冷冻胚胎解冻移植的患者的临床资料进行回顾性分析。共 845 例分为优质卵裂胚胎组（A 组）和低质量囊胚组（B 组）。每组根据移植数量进一步分为亚组。A 组分为 2 个亚组，包括 A1 亚组 94 例（1 个优质 8 细胞组）和 A2 亚组 201 例（2 个优质 8 细胞组）。B 组分为 4 个亚组，包括 B1 亚组 73 例（D53BC 组）、B2 亚组 65 例（D54BC 组）、B3 亚组 110 例（D63BC 组）和 B4 亚组 282 例（D64BC 组）。比较各组妊娠结局和新生儿结局。A2 亚组和 B2 亚组的临床妊娠率（56.72%和 60.00%）和活产率（47.76%和 46.15%）无显著差异，但均显著高于其余亚组（P<0.05）。A2 亚组的多胎率（26.32%）显著高于其余亚组（P<0.05）。各组流产率无统计学差异（P>0.05）。新生儿结局方面，低体重儿和巨大儿的早产率、性别比和出生缺陷比例无统计学差异（P>0.05）。在冷冻-解冻胚胎移植周期中移植 2 个优质卵裂胚胎可显著提高临床妊娠率和活产率，但同时也增加了多胎妊娠和母婴并发症的风险。D54BC 亚组在所有亚组中具有最显著的优势（P<0.05）。其余低质量囊胚的临床结局与单个优质卵裂胚胎组相似。
