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目的:观察无原核(PN)胚胎的发生率、影响因素及移植0PN胚胎周期的临床治疗结局。方法:回顾性分析4 424个IVF-ET周期移植0PN来源胚胎的结局。结果:0PN胚胎的发生率为11.3%。女方的年龄、获卵数及优质胚胎率与0PN的发生率相关。70个周期移植了112个0PN来源的卵裂期胚胎,获得的临床妊娠率为24.3%(17/70),植入率为17.0%(19/112),流产率为11.8%(2/17)。1例死产。13个周期活产13个健康子代,未见畸形的发生。对0PN来源的囊胚进行复苏周期移植,可获得与2PN囊胚相似的临床妊娠率及植入率,但流产率较高,差异有统计学意义。结论:IVF周期中,含有0PN优质胚胎的周期可能有较好的临床治疗结局。形态正常的0PN胚胎有较好的胚胎发育潜能,在无2PN胚胎的情况下,可考虑移植0PN来源胚胎。
Objective: To observe the incidence of prokaryotic (PN) embryos, the influencing factors and clinical outcome of 0PN embryo transfer. Methods: The outcomes of 4 424 IVF-ET cycles of 0PN-derived embryos were retrospectively analyzed. Results: The incidence of 0PN embryos was 11.3%. The woman’s age, number of oocytes retrieved and high-quality embryos were related to the incidence of 0PN. At the 70 cycles, 112 0PN-derived cleaved embryos were transplanted. The clinical pregnancy rate was 24.3% (17/70), the implantation rate was 17.0% (19/112) and the abortion rate was 11.8% (2/17 ). 1 case of stillbirth. Thirteen live births of 13 healthy offspring, no deformity occurred. The 0PN-derived blastocysts were resuscitated and cycle-transplanted, the clinical pregnancy rate and implantation rate similar to that of 2PN blastocysts were obtained, but the abortion rate was higher, the difference was statistically significant. CONCLUSIONS: Cycles containing 0PN high quality embryos in the IVF cycle may have a better clinical outcome. 0PN morphologically normal embryos have a good embryonic development potential in the absence of 2PN embryos can be considered transplanted 0PN-derived embryos.