内细胞团及滋养外胚层对体外受精单囊胚移植结局的影响

摘要

Objective To investigate the clinical value of selective single blastocyst transfer , and effect of blastocyst developmental potential of the inner cell mass (ICM) and trophectoderm(TE) by non-selective single blas-tocyst transfer study .Methods Two hundreds and seventy-six cycles of non-selective single blastocyst transfer in the center were selected and the rate of pregnancy and the early abortion rate of high -quality single blastocyst were com-pared with non-quality single blastocyst ,and the rate of pregnancy and the early abortion rate in different levels of ICM and TE were compared .Results The clinical pregnancy rate of quality single blastocyst transfer was significantly higher than that of non-quality single blastocyst transfer ( P<0.05 );the clinical pregnancy rate of ICM for A was sig-nificantly higher than that of ICM for C ( P<0.05 ); the clinical pregnancy rate of TE for A was significantly higher than that of the TE for B or C ( P<0.05 ); the early abortion rate between the groups was not significant; Multiple pregnancy rate was 1.16%.Conclusion Multiple birth rate of single blastocyst transfer is very low; Quality single blastocyst transfer can get a higher clinical pregnancy rate than non-quality single blastocyst transfer;CC can obtain a low pregnancy rate , so in no other case of embryos , CC blastocyst can be transferd after the fully informed consent .%目的：通过对非选择性单囊胚移植研究，探讨选择性单囊胚移植的临床价值以及内细胞团（ICM）、滋养外胚层（TE）在囊胚发育潜能中的作用。方法选择该中心非选择性单囊胚移植276周期，比较优质单囊胚与非优质单囊胚妊娠率、早期流产率；比较不同ICM和TE妊娠率、早期流产率。结果优质单囊胚移植临床妊娠率较非优质单囊胚临床妊娠率显著增高（ P＜0．05）；ICM A组的临床妊娠率较ICM C组的妊娠率显著增高（ P＜0．05）；TE A组的临床妊娠率较TE B组及TE C组显著增高（ P＜0．05）；各组早期流产率差异无统计学意义；多胎妊娠率为1．16％。结论单囊胚移植多胎率极低；优质单囊胚移植比非优质单囊胚移植可以获得较高临床妊娠率；CC级的囊胚仍有一定的妊娠率，在无其他可移植胚胎的情况下，经充分知情同意，可考虑移植CC级囊胚。