摘要
目的分析供、受卵双方体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)的临床结局及相关影响因素,以期为供、受卵方案的选择提供更多参考。方法回顾性分析2019年1月至2024年8月在我院生殖医学科行IVF/ICSI-ET治疗的159例供卵者(供卵组)和209例受卵者(受卵组)的临床资料,比较供卵组与受卵组的基本情况、囊胚培养情况及妊娠结局,分析供卵组供卵后不同自用卵子数组的可冷冻胚胎数、累积妊娠率及累积活产率的差异。结果两组基本资料比较,受卵组的年龄、不孕年限、基础FSH显著高于供卵组(P<0.05);受卵组均采用ICSI授精,ICSI比例显著高于供卵组(P<0.05)。受卵组的正常受精率(85.65%vs.69.92%)、优质胚胎率(72.91%vs.63.55%)和囊胚形成率(74.29%vs.66.53%)显著高于供卵组(P<0.05),无可利用胚胎取消周期率亦显著高于供卵组(17.22%vs.0.00%,P<0.05)。供卵组共移植224个周期[鲜胚移植22个周期,冻融胚胎移植(FET)202个周期],受卵组全部采用FET,共131个周期;两组间临床妊娠率、活产率及早期流产率比较均无显著性差异(P>0.05),但供卵组的累积妊娠率(91.89%vs.60.66%)、累积活产率(64.19%vs.40.16%)显著高于受卵组(P<0.05)。将供卵组按照供卵后自用卵子数量不同进行分层分析,结果显示自用卵子数15~20枚组患者的可冷冻胚胎数显著低于21~25枚、26~30枚及>30枚组(P<0.05);不同卵子数各组间累积妊娠率比较无显著性差异(P>0.05),但自用卵子数超过25枚时其累积妊娠率有逐渐降低的趋势。自用卵子数26~30枚、>30枚组的累积活产率显著低于21~25枚组(48.57%、50.00%vs.76.47%,P<0.05)。结论供卵2~4枚不影响供卵者妊娠结局;受卵者每周期接受2枚成熟卵,采用ICSI授精,可获得较满意的临床妊娠结局。
Objective:To analyze the clinical outcomes and related influencing factors of IVF/ICSI-ET for both oocyte donors and recipients in order to provide more references for the selection of oocyte donation plans.Methods:A retrospective analysis was conducted on the clinical data of 159 donors(the donor group)and 209 recipients(the recipient group)who underwent IVF/ICSI-ET treatment in the Department of Reproductive Medicine at Eastern Theater Command Hospital from January 2019 to August 2024.The basic information,blastocyst culture,and pregnancy outcomes of the donors and recipients were analyzed.The differences in the number of frozen embryos,cumulative pregnancy rate,and cumulative live birth rate were analyzed among oocyte donors with different numbers of self-used oocytes after oocyte donation.Results:The comparison of basic data between the two groups showed that the age,infertility duration,and baseline FSH level of the recipient were significantly higher than those of the donor group(P<0.05).The recipients were all fertilized using ICSI,and the proportion of ICSI was significantly higher than that of the donor group(P<0.05).The normal fertilization rate(85.65%vs.69.92%),high-quality embryo rate(72.91%vs.63.55%),and blastocyst formation rate(74.29%vs.66.53%)of the recipient group were significantly higher than those of the donor group(P<0.05),and the rate of cycle cancellation without available embryos was also significantly higher than that of the donor group(P<0.05).The donor group underwent a total of 224 cycles of embryo transfer[22 cycles for fresh embryo transfer and 202 cycles for freeze-thaw embryo transfer(FET)],while the recipient group underwent a total of 131 cycles of FET transfer.There was no significant difference in clinical pregnancy rate,live birth rate,and early miscarriage rate between the two groups(P>0.05),but the cumulative pregnancy rate(91.89%vs.60.66%)and cumulative live birth rate(64.19%vs.40.16%)of the donor group were significantly higher than those of the recipient group(P<0.05).Stratified analysis of oocyte donors based on the number of self-used oocytes after donation showed that the number of frozen embryos in the 15-20 self-used oocyte group was significantly lower than those in the 21-25,26-30,and more than 30 groups(P<0.05).There was no significant difference in the cumulative pregnancy rate between groups among different numbers of oocytes(P>0.05),but the cumulative pregnancy rate gradually decreased when the number of self-used oocytes exceeded 25.The cumulative live birth rates of the self-use oocyte groups with 26-30 oocytes and more than 30 oocytes were significantly lower than that of the group with 21-25 oocytes(48.57%,50.00%vs.76.47%,P<0.05).Conclusions:Providing 2-4 oocytes has no effect on the pregnancy outcome of the donor.The clinical pregnancy outcomes could be achieved with satisfaction when a recipient receives 2 mature(MII)oocytes per cycle and is fertilized using ICSI.
作者
林莹
陈莉
唐旭
伏海燕
吴蓉花
李晓艳
许娟娟
LIN Ying;CHEN Li;TANG Xu;FU Hai-yan;WU Rong-hua;LI Xiao-yan;XU Juan-juan(Department of Reproductive Medicine,Eastern Theater Command Hospital,Nanjing 210002)
出处
《生殖医学杂志》
2025年第6期777-783,共7页
Journal of Reproductive Medicine
基金
东部战区总医院院管课题(22LCZLXJS29)
江苏省医学重点学科建设单位项目(JSDW202215)
江苏省卫生健康委科研项目(ZD2022004)。
关键词
冻融胚胎移植
供卵
受卵
妊娠结局
Freeze-thaw embryo transfer
Oocyte donation
Oocyte recipient
Pregnancy outcome
