| CHAPTER 1OBJECTIVE:We analyze the influences of different numbers of transferred good quanlity embryos to multiple gestation rates when in patients of different female age and cycles in order to find the optimal strategy------the number of transferred embryos can reduce the multiple gestation and stabilize the pregnancy rate.MATERIALS AND METHODS:In this retrospective study, a total of 17442 patients who conducted assisted reproductive technology was analyzed between Jan.2009 and Sept.2010. We analyze the different multiple gestation rates according to the No. of transferred embryos (1,2 and 3), the female age (<35 years old,35years old to 39 years old,>39 years old) and treatment cycles.RESULTS:1.The multiple gestation occurred mostly in the patients less than 35 years old. The most (84.7%)double gestation occurred in the patients less than 35 years old who transferred 2 or 3 embryos. The most (56.54%) triple gestation occurred in the patients less than 35 years old who transferred 3 embryos.2.The pregnancy rates of the groups that transferred 1 embryo,2 embryos,3 embryos were 27.22%,59.2%, 57.6%in women age<35,who conducted fresh cycles,there were no significant differences between the latter two groups. The multiple pregnancy rates of these groups were 3.26%,37.70%,46.83%. The pregnancy rates of the groups that transferred 1 embryo,2 embryos,3 embryos were 14.55%,31.6%,49.5%in women age between 35 to 39,who conducted fresh cycles,there were significant differences between them. The multiple pregnancy rates of these groups were 0%, 20.63%,38.89%. The pregnancy rates of the groups that transferred 1 embryo,2 embryos,3 embryos were 10.83%,14.9%,25.4%, in women age> 39,who conducted fresh cycles,there were no significant differences between later two groups. The multiple pregnancy rates of these groups were 0%,11.11%,20.24%.CONCLUSION:1. The multiple gestation occurred mostly in the patients less than 35 years old.2. We should transfer 2 embryos in the patients less than 35 to reduce triple gestation, to further reduce the double gestation, we suggest selective single embryo transfer.3. The patients more than 39 years old is insusceptible to multiple gestation because of their poor implantation rates.CHAPTER 2OBJECTIVE:To observe the differences in pregnancy rates (PRs), delivery rates, and abortion rates associated with frozen-embryo-transfer (FET)-based use of post-thawing embryos with different numbers of blastomeres.MATERIALS AND METHODS:959 FET cycles and 361 successful FET cycles performed between January 2007 and December 2007. Compare the PRs and abortion rates in post-thawing embryos with 8 blastomeres (8c),7c,6c,5c,4c,and 3c.RESULTS:1. The total PRs of post-thawing 8c,7c,6c,5c,4c, and 3c embryos were 44.1%,41.0%,34.4%,23.8%,12.5%, and 0%, respectively (p<0.05).2. The abortion rates for the transferred embryos of the 8c,7c, 6c,5c, and 4c groups were 17.92%,19.35%,27.69%,24%,20%, respectively (p<0.05).CONCLUSION:The number of blastomeres in the post-thawing embryos is an important factor influencing the occurrence of pregnancy in FET procedures; however, the criterion that post-thawing embryos with 50% intact blastomeres will lead to pregnancy may not be valid.CHAPTER 3OBJECTIVE:To compare the pregnancy after vitrification for human cleaved embryos and human blastocysts.MATERIALS AND METHODS:Retrospective analysis of 820 patients who conduct embryos vitrification from Jun.2010 to Dev.2010. Include 597 patients who conduct vitrification of cleaved embryos,67 patients who conduct vitrification of blastocysts and 156 patients whose cleaved embryos conduct blastocyst culture after warming.RESULTS:In 820 vitrified embryo thaw cycles,775 cycles were transferred,314 were obtained success pregnancy. The pregnancy rates was 40.52%. The survival rates of cleaved embryos, blastocysts and cleaved embryos conduct blastocyst culture after warming, were 93.31%(1423/1525),93.28%(125/134),92.16%(835/906) respectively, and the pregnancy rates were 38.55%(224/581),49.25%(33/67), 44.88%(57/127). The survival rates of open vitrification carrier Cryoleaf、Cryotop、Fibreplug and closed vitrification carrier HSV were 93.67%, 93.59%,92.88% and 93.23%,the implantation rates among these groups were 23.14%,25.23%,22.95% and 23.26%,and the pregnancy rates were 38.76%,38.27%,38.19% and 39.43% respectively.CONCLUSION:The survival rates of these three groups showed no statistical differences.The pregnancy rate of vitrified blastocysts are higher than those of cleaved embryos and cleaved embryos conduct blastocyst culture after warming. The closed vitrification carrier showed same freeze efficiency as the open vitrification carrier. |
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