在辅助生殖技术中,胚胎转移是囊胚阶段与裂解阶段的对比
Demián Glujovsky1, Simone Cornelisse2, Deborah Blake3
1Scientific Dept, CEGYR (Centro de Estudios en Genética y Reproducción), Buenos Aires, Argentina.
The Cochrane database of systematic reviews
|January 23, 2026
概括
胚胎移植可能会增加累积的活产率,但与切割阶段移植相比,也会增加早产的风险. 需要进一步的研究来澄清所有患者群体的长期结果和益处.
科学领域:
- 生殖医学 生殖医学
- 在体外受精 (IVF)
- 胚胎学 胚胎学
背景情况:
- 在试管婴儿中,胚胎转移到囊胚阶段越来越受青,而不是切割阶段转移.
- 这种转变是基于改善胚胎-子宫内膜同步和可活胚胎的自我选择的假设.
- 关于真正的生物优势与体外选择相比以及对累积活产率的影响,仍然存在不确定性.
研究的目的:
- 在辅助生殖技术循环中,比较胚胎移植的胚胎转移阶段 (5-6天) 与分裂阶段 (2-3天).
- 评估对每名妇女累积活产率 (cLBR),每名新转移活产率 (LBR) 和累积早产率的影响.
主要方法:
- 一个系统的审查和36个随机对照试验 (RCTs) 的元分析,涉及8389名参与者.
- 搜索了多个数据库,包括Cochrane,MEDLINE,Embase和试验注册表.
- 使用Cochrane的RoB 2工具评估偏差风险和使用GRADE的证据确定性.
主要成果:
- 胚胎细胞转移可能会增加12个月内cLBR (OR 1.24,低确定性) 和每次新转移的LBR (OR 1.39,中等确定性).
- 累积的早产率似乎更高,与胚胎细胞移植 (或1.72,中等确定性).
- 每次新转移的临床怀孕率可能更高 (OR1.31,低确定性),流产率差异很小. 胚胎冷可能较低,而移植失败可能更高.
结论:
- 囊胞移植可能会改善预后良好妇女每次新移植的cLBR和LBR,但可能会增加累积早产率.
- 分裂阶段的转移可能会导致更多的胚胎结和更少的转移失败.
- 由于大多数结果的证据确定性较低,结果不确定;结果可能不适用于预后不佳的女性. 建议对长期结果进行进一步的研究.
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