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生化妊娠和早期流产风险的胚胎学观点:一个回顾性队列研究

Jinliang Zhu¹, Jialin Jia¹, Shengli Lin¹

¹Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China; State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China.

European journal of obstetrics, gynecology, and reproductive biology

|October 23, 2025

概括

胚胎细胞发育速度是早期妊娠损失的关键预测因素. 较快的发育 (第五天) 与较慢的发育 (第六天) 相比,显著降低了生化妊娠和流产率.

科学领域:

生殖医学生殖医学
胚胎学胚胎学
遗传学遗传学是一个

背景情况:

胚胎细胞的发育速度和染色体构成是影响早期怀孕结果的潜在因素.
植入前遗传检测 (PGT) 旨在通过选择染色体正常的胚胎来提高试管婴儿成功率.
胚胎囊形态,发育时间和妊娠损失之间的相关性需要进一步调查.

研究的目的:

调查胚胎细胞发育速度,染色体构成和形态分级与怀孕结果之间的关联.
确定植入前遗传测试 (PGT) 对生化妊娠,早期流产和整体妊娠流产的影响.
确定冷单胞胎转移周期中早期妊娠损失的最重要的预测因素.

主要方法:

对12527个冷单胞胎移植周期 (2022年1月至2023年12月) 的回顾性分析.
在植入前基因测试 (PGT) 组 (2,104个周期) 和非PGT组 (10,423个周期) 之间的比较.
分析包括胚胎细胞发育速度 (5日与6日),染色体状态 (euploid与aneuploid) 和形态分级.

主要成果:

与第6天胚胎囊相比,第5天胚胎囊的转移显著降低了生化妊娠 (8.4%vs. 16.5%) 和早期流产率 (15.8%vs. 24.5%),无论PGT如何.
调整后的几率比率表明,生物化学怀孕 (0.48),早期流产 (0.65) 和整体怀孕流产 (0.51) 的风险与第5天的胚胎细胞显著降低.
与未经测试的母细胞囊相比,欧普洛伊德母细胞囊的早期流产率 (aOR=0.75) 降低了,而形态分级与妊娠结果没有显著的相关性.

结论:

胚胎细胞发育速度是生化妊娠和早期妊娠流产的最强有力的预测因素.
植入前遗传检测 (PGT) 与早期流产的风险降低有关.
根据发育速度优化胚胎细胞移植时间可能会提高试管婴儿成功率.

关键词:

有助于生殖的辅助生殖技术生化妊娠是一个生化妊娠.发展速度的发展速度.早期流产早期流产在植入前进行遗传检测.

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