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投稿时间：2021-09-25 网络发布日期：2022-04-20
投稿时间：2021-09-25 网络发布日期：2022-04-20
中文摘要: 目的 探讨激光辅助孵化（LAH）对反复种植失败（RIF）患者行冻融卵裂期胚胎移植临床结局的影响。
方法 选取2018年6月至2020年6月在山西医科大学第一医院生殖科接受体外受精（IVF）/卵胞浆内单精子注射—胚胎移植（ICSI-ET）助孕治疗的RIF患者381例进行回顾性研究，将381例分为A、B两组，A组为LAH组249例，移植前行LAH；B组作为对照组132例，移植前未行LAH。从A组、B组中分别选取高龄（年龄≥35岁）患者为A1组、B1组，分别选取高基础卵泡刺激素（FSH）（FSH≥10 iu/L）患者为A2组、Ｂ2组。比较A组与B组、A1组与B1组、A2组与B2组患者之间的胚胎种植率、临床妊娠率、异位妊娠率、多胎妊娠率及早期流产率。
结果 A组患者异位妊娠率、多胎妊娠率及早期流产率与B组比较差异无统计学意义，胚胎种植率、临床妊娠率略高于B组，但差异无统计学意义（P＞0.05）。A1组患者LAH后异位妊娠率、多胎妊娠率、早期流产率与B1组比较差异无统计学意义（P＞0.05），但胚胎种植率、临床妊娠率A1组显著高于B1组，差异有统计学意义（P＜0.05）。A2组患者LAH后异位妊娠率、多胎妊娠率、早期流产率与B2组比较差异无统计学意义（P>0.05），胚胎种植率、临床妊娠率A2组显著高于B2组，差异有统计学意义（P＜0.05）。各组均未发生新生儿畸形。结论 LAH可改善RIF患者的临床妊娠结局，尤其对高龄或高FSH的RIF患者的冻融胚胎移植改善作用更明显。
Abstract:Objective To retrospectively analyze the effect of laser-assisted hatching （LAH） on the clinical outcome of freeze-thawed cleavage embryo transfer in patients with repeated implantation failure （RIF）.
Methods A total of 381 RIF patients who received in vitro fertilization/intracytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET） assisted fertility treatment in the Department of Reproduction of First Hospital of Shanxi Medical University from June 2018 to June 2020 were selected as the research subjects, and were divided into group A (LAH group, 249 cases, LAH performed before transplantation) and B group (control group, 132 cases, no LAH performed before transplantation). From group A and group B, elderly patients （aged≥35 years） were selected as group A1 and group B1 respectively, and patients with high basal follicle stimulating hormone （FSH） （FSH≥10 iu/L） were selected as group A2 and group B2 respectively. The embryo implantation rate, clinical pregnancy rate, ectopic pregnancy rate, multiple pregnancy rate and early abortion rate were compared between group A and group B, group A1 and group B1, group A2 and group B2.
Results There was no significant difference in ectopic pregnancy rate, multiple pregnancy rate and early abortion rate between group A and group B, while embryo implantation rate and clinical pregnancy rate of group A were higher than those of group B, but the differences were not statistically significant （P＞0.05）.There was no statistical significance in the ectopic pregnancy rate, multiple pregnancy rate and early abortion rate after LAH in group A1 compared with group B1, but embryo implantation rate and clinical pregnancy rate of group A1 were significantly higher than those of group B1 （P＜0.05）. There was no statistical significance in ectopic pregnancy rate, multiple pregnancy rate and early abortion rate after LAH in group A2 compared with group B2 （P>0.05）, but embryo implantation rate and clinical pregnancy rate of group A2 were significantly higher than that of group B2 （P＜0.05）.
Conclusion LAH can improve the clinical pregnancy outcome of RIF patients, especially for the freeze-thawed embryo transfer in elderly RIF patients and RIF patients with high FSH.
keywords: Laser-assisted hatching Repeated implantation failure Freeze-thawed embryo transfer Embryo implantation rate Clinical pregnancy rate
文章编号： 中图分类号：R711.6 文献标志码：A
基金项目:
| 作者 | 单位 |
| 鹿玉琨1 | 1. 山西医科大学第一临床医学院，山西 太原 030000； |
| 土增荣2 | 2. 山西医科大学第一医院生殖医学科，山西 太原 030000 |
| 王丽媛2 | 2. 山西医科大学第一医院生殖医学科，山西 太原 030001 |
| 高瑞璠2 | 2. 山西医科大学第一医院生殖医学科，山西 太原 030002 |
| 段瑞云2 | 2. 山西医科大学第一医院生殖医学科，山西 太原 030003 |
| Author Name | Affiliation |
| LU Yu-kun*, TU Zeng-rong, WANG Li-yuan, GAO Rui-fan, DUAN Rui-yun | *The First Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030000, China |
引用文本：
鹿玉琨,土增荣,王丽媛,等.激光辅助孵化对反复种植失败患者行冻融卵裂期胚胎移植临床结局的影响[J].中国临床研究,2022,35(4):472-476.
鹿玉琨,土增荣,王丽媛,等.激光辅助孵化对反复种植失败患者行冻融卵裂期胚胎移植临床结局的影响[J].中国临床研究,2022,35(4):472-476.