目的:探讨选择2个胚胎移植对IVF—ET与ICSI助孕结局的影响。方法:回顾2008年12月-2010年9月在福建省妇幼保健院接受体外受精-胚胎移植(IVF—ET)的494个新鲜周期病例,对3天体外培养胚胎进行全面评级后,各年龄组均选择2个胚胎移植,按含0、1、2个优质胚胎分成3组,比较其对助孕结局的影响。结果:494周期中,2个均为优质胚胎移植的391个周期,占79.14%;含1个优质胚胎移植的74个周期,占15.00%;2个均非优质胚胎移植的29个周期,占5.87%。总的周期妊娠率为40.16%,种植率为25.81%,多胎率为27.27%,其中4例为3胎,50例为双胎。选择2个优质胚胎移植组妊娠率为46.04%,种植率为30.05%,多胎率为29.44%。结论:通过提高优质胚胎选择的准确性,选择2个最优质胚胎移植有助于提高胚胎着床能力和临床妊娠率,获得良好的妊娠结局,但多胎妊娠的发生率并不降低。
Objective: To explore the effect of two - embryo transfer on pregnancy outcomes of in vitro fertilization - embryo trans- fer (IVF -ET) and intracytoplasmic sperm injection (ICSI) . Methods: A total of 494 fresh cycles in the cases who were treated with IVF- ET in the hospital from December 2008 to September 2010 were analyzed retrospectively, two embryos were selected for transfer in each group after assessing the embryos cultured in vitro for 3 days, then they were divided into none - embryo group, one - embryo group, and two - embryo group according the number of high quality embryos, the effects on pregnancy outcomes were compared. Results: Among 494 cycles, the proportion of cycles with both two high quality embryos was 79. 14% (391 cycles) ; 74 cycles contained one high quality em- bryo, accounting for 15.00% ; 29 cycles contained no high quality embryo, accounting for 5.87%. Tile total cycle pregnancy rate was 40. 16%, the implantation rate was 25.81%, the rate of polybryony was 27.27%, including 4 cases with triplets and 50 cases with twins; the pregnancy rate, implantation rate, and polybryony rate in two - embryo group were 46.04%, 30.05%, and 29.44%, respectively. Conclusion: To improve the accuracy of selecting high quality embryos, two high quality embryos transfer may help to improve the embryo implantation capability and clinical pregnancy rate, achieve good pregnancy outcome, but the method cant reduce the incidence of multiple pregnancy.