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中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (06) : 782 -786. doi: 10.3877/cma.j.issn.1673-5250.2013.06.015

所属专题: 文献

论著

辅助生殖后单卵双胎的妊娠结局分析
程丹1,*,*(), 杨菁1, 徐望明1, 徐梅1, 邹宇洁1   
  1. 1. 430060 武汉,武汉大学人民医院生殖医学中心
  • 收稿日期:2013-05-10 修回日期:2013-11-04 出版日期:2013-12-01
  • 通信作者: 程丹

Pregnancy Outcomes analysis of Monozygotic Twinnings After Assisted Reproductive Techniques

Dan CHENG1(), Jing YANG1, Wang-ming XU1, Mei XU1, Yu-jie ZOU1   

  1. 1. Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
  • Received:2013-05-10 Revised:2013-11-04 Published:2013-12-01
  • Corresponding author: Dan CHENG
  • About author:
    (Corresponding author : CHENG Dan, Email : )
引用本文:

程丹, 杨菁, 徐望明, 徐梅, 邹宇洁. 辅助生殖后单卵双胎的妊娠结局分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2013, 09(06): 782-786.

Dan CHENG, Jing YANG, Wang-ming XU, Mei XU, Yu-jie ZOU. Pregnancy Outcomes analysis of Monozygotic Twinnings After Assisted Reproductive Techniques[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2013, 09(06): 782-786.

目的

探讨辅助生殖后单卵双胎(MT)发生率和妊娠结局。

方法

回顾性分析2010年1月至2012年6月在武汉大学人民医院生殖医学中心行辅助生殖获得临床妊娠的患者资料,对比分析MT患者与同期未发生MT患者的辅助生殖临床资料,早、中孕期的流产率与活胎分娩率(本研究遵循的程序符合武汉大学人民医院伦理委员会制定的伦理学标准,得到该委员会批准)。

结果

获得临床妊娠的1710个周期中,MT为16例,发生率为0.94%。其中获得妊娠方式为体外受精-胚胎移植(IVF-ET)者为4例(0. 63%),单精子卵胞浆内显微注射-胚胎移植(ICSI-ET)为4例(1.00%),冻融胚胎移植(FET)为8例(1.18%)。MT多胎妊娠发生率[MT合并单卵单胎(MP)的三胎妊娠]为6例(37. 50%),流产为3例(18.8%)。MT患者较非MT患者的流产率高,活胎分娩率低。鲜胚移植中受精方式分别为IVF-ET和ICSI-ET的MT患者与非MT患者比较,MT患者的年龄较低(P<0. 05),但不孕年限、促性腺激素(Gn)使用时间、Gn使用剂量、获卵数、受精数、卵裂数、可用胚胎数等比较,差异均无统计学意义(P>0. 05),MT患者的平均移植胚胎数较非MT者高,但二者比较,差异亦无统计学意义(P>0. 05)。行FET的MT患者与非MT患者的子宫内膜准备方式方面,移植日子宫内膜厚度和平均移植胚胎个数比较,差异均无统计学意义(P>0.05)。

结论

辅助生殖的MT在冻胚移植中发生率高,发生MT病例流产率高,妊娠结局不良,在辅助生殖中如何降低MT的发生仍需要进一步研究。

Objective

To explore incidence rate of monozygotic twinnings (MT) and pregnancy outcomes in patients undergoing assisted reproductive technique.

Methods

Pregnant cases undergoing assisted reproductive technique [in vitro fertilization and embryo transfer (IVF-ET) , Introcytoplasmic sperm injection and embryo transfer (ICSI-ET) and frozen-refreshed embryo transfer (FET)] from January 2010 to June 2012 were collected in Reproductive Medical Center of Renmin Hospital, Wuhan University. Abortion rates and live birth rates were compared between MT and non-MT patients. The study protocol was approved by the Ethical Review Board of Investigation in Renmin Hospital of Wuhan University. Informed consent was obtained from all participates.

Results

1710 cycles with clinical pregnancy were collected. There were 16 MTs (0. 94%),among which 4 cases(0. 63%) occurred in IVF-ET, 4(1. 00%) occurred in ICSI-ET,8(1. 18%) occurred in FET. In MT twins,6 individuals (37. 5%) were accompanied by multi-pregnancy, 3(18.8%) accompanied by abortion. No statistical significances were observed in duration of infertility, period of gonadotropin (Gn) treatment, Gn dosage, number of oocytes,zygotes, blastocysts and accessible embryos between MT patients and non-MT patients. Numbers of embryos transferred were higher in MT patients,but failed to reach a statistical difference. No differences were observed in endometrial thickness and number of embryos transferred between MT patients and non-MT patients in FET treatment. Abortion rate was higher and live birth rate was lower than those in non-MT patients.

Conclusions

MT twins were seen more often in cases with frozen embryo transferred, accompanied by a higher abortion rate and poorer pregnancy outcomes. It required further investigation about how to reduce the incidence of MT using assisted reproductive technique.

表1 获得妊娠方式与MT发生率、MT多胎发生率的关系[n(%)]
Table 1 The incidences of monozygote twinning and multiple pregnancy in groups with different pattern of achieving pregnancy [n(%)]
表2 鲜胚妊娠MT与非MT临床与实验室资料的比较(±s)
Table 2 Comparision of clinical and laboratory characteristics between MT and non-MT patients after fresh embryo transfer (± s)
表3 冻胚移植妊娠MT组与非MT组资料的比较(±s
Table 3 Comparision of datas between MT and Non-MT patiens after frozen-refresh embryo transfer (±s)
表4 随访结果[n(%)]
Table 4 Results of follow-up[n(%)]
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