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不同年龄女性的囊胚移植策略

Blastocyst Transplantation Strategies in Women of Different Ages.

作者信息

Yang Dandan, Chai Menghan, Yang Ni, Yang Han, Wen Xingxing, Wang Jing, Fan Yongqi, Cao Yunxia, Zhang Zhiguo, Chen Beili

机构信息

Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei 230032, China.

NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, China.

出版信息

J Clin Med. 2023 Feb 17;12(4):1618. doi: 10.3390/jcm12041618.

Abstract

(1) Background: Single blastocyst transfers (SBT) and double blastocyst transfers (DBT) are widely used in clinical practice. The objective of this study was to investigate the application of these two strategies in women of different ages. (2) Methods: Analysis was carried out on 5477 frozen embryo transfer cycles of women in different ages. All the cycles were divided into three groups according to the age of the included women: <35, 35-39, and >39. The live birth rate (LBR) and multiple birth rate (MBR) between the SBT and DBT among these groups, respectively, were compared. (3) Results: In the women < 35 group, the LBR was similar in SBT and DBT, but the MBR was higher in DBT than SBT. In women 35-39, with >10 oocytes retrieved, the MBR in DBT was significantly higher than SBT, but there was no significant difference in LBR between the two groups; with ≤10 oocytes retrieved, the LBR in DBT were significantly higher than SBT, but the MBT was not significantly different between the two groups. In women > 39, the LBR and MBR were lower in the SBT than DBT, but the differences were not statistically significant. (4) Conclusions: Selective SET is appropriate for most young women, whereas older women are advised to make individualized choices based on the number of oocytes retrieved and blastocyst quality.

摘要

(1) 背景:单囊胚移植(SBT)和双囊胚移植(DBT)在临床实践中广泛应用。本研究的目的是调查这两种策略在不同年龄女性中的应用情况。(2) 方法:对5477例不同年龄女性的冻融胚胎移植周期进行分析。根据纳入女性的年龄,所有周期分为三组:<35岁、35 - 39岁和>39岁。分别比较这些组中SBT和DBT之间的活产率(LBR)和多胎出生率(MBR)。(3) 结果:在<35岁的女性组中,SBT和DBT的LBR相似,但DBT的MBR高于SBT。在35 - 39岁的女性中,取卵数>10个时,DBT的MBR显著高于SBT,但两组的LBR无显著差异;取卵数≤10个时,DBT的LBR显著高于SBT,但两组的MBT无显著差异。在>39岁的女性中,SBT的LBR和MBR低于DBT,但差异无统计学意义。(4) 结论:选择性单胚胎移植适用于大多数年轻女性,而建议年长女性根据取卵数和囊胚质量做出个体化选择。

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本文引用的文献

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Guidance on the limits to the number of embryos to transfer: a committee opinion.关于移植胚胎数量限制的指南:委员会意见。
Fertil Steril. 2021 Sep;116(3):651-654. doi: 10.1016/j.fertnstert.2021.06.050. Epub 2021 Jul 28.
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Single embryo transfer for all.单胚胎移植,全面普及。
Best Pract Res Clin Obstet Gynaecol. 2018 Nov;53:30-37. doi: 10.1016/j.bpobgyn.2018.07.001. Epub 2018 Jul 31.
7
Impact of Maternal Age on Oocyte and Embryo Competence.母亲年龄对卵母细胞和胚胎能力的影响。
Front Endocrinol (Lausanne). 2018 Jun 29;9:327. doi: 10.3389/fendo.2018.00327. eCollection 2018.
8
Fetal growth restriction in twins.双胎胎儿生长受限。
Best Pract Res Clin Obstet Gynaecol. 2018 May;49:79-88. doi: 10.1016/j.bpobgyn.2018.02.004. Epub 2018 Feb 24.

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