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目的研究低级别胚胎囊胚的发育潜能、移植新鲜胚囊及冻融囊胚的临床结局,分析低级别胚胎囊胚的培养和移植价值。方法选取行体外受精-胚胎移植(IVF/ICSI-ET)技术的123个治疗周期,将受精后3天(D3)进行移植、冷冻的436枚低级别胚胎继续培养2~3天,观察胚囊的形成情况及临床结局。如患者在下一周期进行囊胚解冻移植,则需分析冻融囊胚及卵裂胚的临床结局。结果低级别胚胎继续培养2~3天,形成囊胚率为32.8%;有囊胚形成组种植率、临床妊娠率高于无囊胚形成组(P<0.05),两组间流产率无明显差异(P>0.05);冻融囊胚组种植率及临床妊娠率高于冻融卵裂胚组(P<0.05),两组间流产率无显著差异(P>0.05)。结论低级别的胚胎通过囊胚培养,可以筛选出最具潜能的胚胎,提高了胚胎的利用率和临床妊娠率。
Objective To study the developmental potential of low-grade embryo blastocysts, the clinical outcomes of fresh embryo transfer and frozen-thawed blastocysts, and to analyze the culture and transplantation value of low-grade embryo blastocysts. Methods 123 cycles of in vitro fertilization-embryo transfer (IVF / ICSI-ET) were selected. Three days after fertilization (D3) were transplanted. Frozen 436 low-grade embryos were cultured for 2-3 days. The formation and clinical outcome. If the patient undergoes blastocyst thawing in the next cycle, the clinical outcome of the frozen-thawed blastocysts and cleaved embryos needs to be analyzed. Results The low-grade embryos were cultured for 2 to 3 days and the rate of blastocyst formation was 32.8%. The implantation rate and clinical pregnancy rate of blastocyst-forming group were higher than those without blastocyst formation (P <0.05) (P> 0.05). The implantation rate and clinical pregnancy rate in frozen-thawed blastocyst group were higher than that in frozen-thawed blastocyst group (P <0.05). There was no significant difference in abortion rate between the two groups (P> 0.05). Conclusion The low-grade embryos can be selected by blastocyst culture to screen the most potential embryos and improve the embryo utilization rate and clinical pregnancy rate.