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目的:探讨第3日冻融胚胎合适的移植策略。方法:收集在本院行卵裂期(第3日)冷冻胚胎移植(FET)的3 694个周期的患者资料进行回顾性分析,根据移植胚胎数将患者分为移植1枚胚胎组(A组)、2枚胚胎组(B组)和3枚胚胎组(C组)。依据患者年龄分别再分为不同的年龄组(1组<35岁、2组35~39岁、3组≥40岁);另根据胚胎质量分优质胚胎组和非优质胚胎组。结果:A、B、C组临床妊娠率分别为23.03%、43.95%、40.18%,A组与B组间及A组与C组间比较,均有统计学差异(P<0.01)。A1、A2、A3 3组的临床妊娠率分别为28.34%、18.84%、8.33%,A1与A3组间有统计学差异(P<0.01);B1、B2、B3 3组的临床妊娠率分别为48.13%、34.50%、15.23%,各组间两两比较均有统计学差异(P<0.01);C1、C2、C3 3组的临床妊娠率分别为45.24%、36.63%、16.67%,C1与C3组间以及C2与C3组间比较,均有统计学差异(P<0.01,P<0.05)。临床妊娠率在A、B、C组≥40岁亚间均无统计学差异(P>0.05)。A、B、C组中移植优质胚胎者的临床妊娠率显著高于非优质胚胎者(P<0.01)。结论:第3日FET周期中,应依据患者年龄和胚胎质量对不同患者制定个体化的移植方案。选择性单囊胚移植是今后的努力方向。
Objective: To investigate the suitable transplantation strategy of the 3rd day frozen-thawed embryos. Methods: Data of 3694 cycles of frozen embryo transfer (FET) in our hospital were analyzed retrospectively. According to the number of transferred embryos, the patients were divided into one embryo group (group A) ), Two embryos (group B) and three embryos (group C). According to the patient’s age were divided into different age groups (1 group <35 years old, 2 groups of 35 to 39 years old, 3 groups ≥ 40 years old); the other according to embryo quality divided into high quality embryos and non-high quality embryos. Results: The clinical pregnancy rates in groups A, B and C were 23.03%, 43.95% and 40.18%, respectively. There was significant difference between group A and group B and group A and group C (P <0.01). The clinical pregnancy rates in groups A1, A2 and A3 were 28.34%, 18.84% and 8.33%, respectively, and there was a significant difference between A1 and A3 (P <0.01). The clinical pregnancy rates in groups B1, B2 and B3 were The clinical pregnancy rates in C1, C2 and C3 3 groups were 45.24%, 36.63% and 16.67% respectively, and C1 and There were significant differences between C3 group and C2 and C3 groups (P <0.01, P <0.05). The clinical pregnancy rate in the A, B, C group ≥ 40-year-old sub-between no significant difference (P> 0.05). The clinical pregnancy rate of high quality embryo transfer in group A, B and C was significantly higher than that in non-high quality embryo (P <0.01). Conclusion: On the 3rd FET cycle, individualized transplant protocols should be developed for different patients based on patient age and embryo quality. Selective single blastocyst transplantation is the direction of future efforts.