广东医学2025，Vol.46Issue(9)：1334-1339,6.DOI:10.13820/j.cnki.gdyx.20244020
基于年龄和胚胎情况探讨D3卵裂期胚胎的冷冻移植策略
Freezing-thawing transfer strategies for day-3 cleavage-stage embryos based on age and embryo quality
摘要
Abstract
Objective To investigate the impact of cleavage-stage embryo number,quality,and patient age on pregnancy outcomes in frozen-thawed embryo transfer(FET)cycles.Methods A retrospective analysis was performed on patients aged ≤40 years who underwent cleavage-stage FET at the Department of Reproductive Medicine,The First Affiliated Hospital of Harbin Medical University,between January 2016 and December 2021.Based on embryo number and quality before cryopreservation,patients were divided into four groups:non-good,single-good,one-good-one-non-good,and double-good.Baseline characteristics and pregnancy outcomes were compared.Multivariate logistic re-gression models were constructed including age,infertility duration,body mass index(BMI),endometrial thickness,treatment protocol,and embryo grouping to analyze factors influencing clinical pregnancy and live birth.Patients with at least one good-quality embryo were further stratified by age into≤ 30,31-35,and 36-40 years,and pregnancy out-comes were compared across groups.Results Significant differences were found in age and infertility duration among the four groups(P＜0.05),while no significant differences were observed in endometrial thickness,BMI,or treatment proto-col(P＞0.05).The double-good group had significantly higher clinical pregnancy,live birth,and multiple pregnancy rates compared with the other three groups(P＜0.008 3).Both double-good and single-good groups showed higher im-plantation rates than the other groups(P＜0.008 3),but no significant difference was found between them(P＞0.008 3).The single-good group had the lowest multiple pregnancy rate(P＜0.008 3).Logistic regression indicated that age was negatively correlated with clinical pregnancy and live birth(aOR=0.93,95％CI:0.92-0.95,P＜0.001;OR=0.93,95％CI:0.91-0.95,P＜0.001),while endometrial thickness was positively correlated(aOR=1.05,95％CI:1.02-1.09,P=0.002;aOR=1.06,95％CI:1.03-1.10,P＜0.001).Embryo grouping significantly influenced outcomes(P＜0.001),and BMI was negatively correlated with live birth(aOR=0.96,95％CI:0.94-0.98,P＜0.001).For patients≤35 years,the double-good group had significantly higher clinical pregnancy and live birth rates than the single-good and one-good-one-non-good groups(P＜0.017),while the latter two did not differ significantly.However,the one-good-one-non-good group had a significantly higher multiple pregnancy rate than the single-good group(P＜0.017).For patients aged 36-40 years,the single-good group had significantly lower clinical pregnancy,live birth,and multiple pregnancy rates and a higher early miscarriage rate than the double-good group(P＜0.017).Conclusion Considering both live birth and multiple pregnancy outcomes,selective single good-quality cleavage-stage embryo transfer is recommended for patients≤35 years,while for patients≥36 years with poorer prognosis,transferring two cleavage-stage embryos or a single blastocyst may be appropriate after informed consent.关键词
体外受精/年龄/冻融胚胎移植/胚胎质量/胚胎移植策略Key words
in vitro fertilization/age/frozen-thawed embryo transfer/embryo quality/embryo transfer strategy分类
医药卫生引用本文复制引用
张洪秀,于慧敏,吕荟明,李甲楠,王秦,刘美龄,吴珩,刘彬..基于年龄和胚胎情况探讨D3卵裂期胚胎的冷冻移植策略[J].广东医学,2025,46(9):1334-1339,6.基金项目
黑龙江省卫生健康委科研课题(20230505030440) （20230505030440）
