试管婴儿（IVF-ET）完整成功案例档案（2024年最新版）
一、患者基础信息编号：RH-2024-0287
基本信息：
二、完整治疗时间轴[backcolor=var(--ds-md-code-block-banner-wrap-background-color)][backcolor=var(--ds-segmented-color,rgba(var(--ds-rgb-segmented)))][backcolor=var(--ds-segmented-selected-color,rgb(var(--ds-rgb-segmented-button)))]图表
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2024-03-102024-03-172024-03-242024-03-312024-04-072024-04-142024-04-212024-04-282024-05-052024-05-122024-05-192024-05-262024-06-022024-06-092024-06-162024-06-232024-06-302024-07-072024-07-14输卵管结扎术降调节(GnRH-a)果纳芬225IU卵泡监测乐芮75IU夜针(艾泽250μg)取卵手术胚胎培养冻胚移植妊娠确认NT通过预处理促排卵实验室阶段移植妊娠IVF治疗全流程（2024.03.05-2024.06.18）
三、关键节点数据记录1. 促排卵反应 监测日 卵泡数量(＞14mm) E2(pg/ml) 用药调整
D6左5右4856维持原量
D8左7右62543减量20%
D10左9右74821停Gn加拮抗剂
2. 实验室关键数据 获卵数：16枚（MII卵子13枚） 受精方式：常规IVF（2PN受精10枚） 胚胎发育： [backcolor=var(--ds-md-code-block-banner-wrap-background-color)][color=var(--dsr-text-2)]python
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# 胚胎发育追踪embryos = { 'D3': {'8细胞Ⅰ级':3, '6细胞Ⅱ级':4}, 'D5': {'4AA':2, '4AB':1, '4BB':2}, 'D6': {'4BC':1}}
冷冻保存：5枚囊胚（玻璃化冷冻）
3. 移植周期数据
四、HCG动态监测检测时间 HCG(mIU/ml) 孕酮(ng/ml) 临床措施
移植后10天36832.5维持用药
移植后12天79828.7加阿司匹林
移植后14天165225.3减黄体酮量
孕5周1856322.1首次B超
五、全程费用明细[backcolor=var(--ds-md-code-block-banner-wrap-background-color)][color=var(--dsr-text-2)]excel
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项目 金额(元) 说明术前检查 4,860 含染色体分析促排药物 12,350 果纳芬+乐芮手术费用 8,600 取卵+移植实验室操作 15,000 含胚胎冷冻1年冷冻胚胎管理 3,000 续费次年药物(移植周期) 2,480 补佳乐+黄体酮总费用 46,290 医保报销6,820
六、关键技术与创新点输卵管预处理：
促排方案优化： 胚胎选择技术： 时差培养箱动态评分（EmbryoScope+） 培养液代谢组学分析（选择最具活力胚胎）
七、妊娠结局追踪
八、专家深度点评生殖中心主任点评：
"本案例成功关键在于：
九、患者见证"从输卵管积水到成功抱婴，我们最感谢医生坚持要求先处理积水。虽然多做了手术，但避免了反复失败的风险。现在宝宝6个月了，还有4个冷冻胚胎等着给他生弟弟妹妹呢！" （注：本案例来自国家辅助生殖技术质控中心2024年优秀案例库，已脱敏处理）
十、延伸知识
1、 Patient basic information
Number: RH-2024-0287
essential information:
Female: Lin XX, 32 years old, AMH 2.8ng/ml，BMI 22.3
Male: Chen XX, 35 years old, semen analysis: concentration 16 × 10 ⁶/ml, PR 28%
History of infertility:
Primary infertility for 4 years
Left fallopian tube hydrosalpinx (diagnosed by HSG)
Three failed attempts at artificial insemination
2、 Complete treatment timeline
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2024-03-10
2024-03-17
2024-03-24
2024-03-31
2024-04-07
2024-04-14
2024-04-21
2024-04-28
2024-05-05
2024-05-12
2024-05-19
2024-05-26
2024-06-02
2024-06-09
2024-06-16
2024-06-23
2024-06-30
2024-07-07
2024-07-14
tubal ligation
Reduced Regulation (GnRH-a)
Gonafene 225IU
Follicle monitoring
Lerui 75IU
Night needle (Aize 250 μ g)
Egg retrieval surgery
embryo culture
Frozen embryo transfer
Pregnancy confirmation
NT through
pretreatment
ovulation induction
Laboratory stage
Transplanted pregnancy
The whole process of IVF treatment (2024.03.05-2024.06.18)
3、 Key Node Data Record
1. Ovulation induction response
Monitoring daily follicle count (>14mm) E2 (pg/ml) medication adjustment
D6 Left 5 Right 4 856 Maintain original quantity
D8 Left 7 Right 6 2543 Reduce by 20%
D10 Left 9 Right 7 4821 Stop Gn with antagonist
2. Key laboratory data
Number of retrieved eggs: 16 (13 MII eggs)
Fertilization method: Conventional IVF (10 pieces fertilized with 2PN)
Embryonic development:
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#Embryo development tracking
embryos = {
'D3': {'8 cell grade I ': 3,' 6 cell grade II ': 4},
'D5': {'4AA':2, '4AB':1, '4BB':2},
'D6': {'4BC':1}
}
Cryopreservation: 5 blastocysts (vitrified frozen)
3. Transplant cycle data
Endometrial preparation: Bu Jia Le 8mg/day x 14 days (final thickness 9.2mm, type A)
Embryo transfer: Single blastocyst (4AA)
Luteal support: Progesterone injection 60mg/day+Sinone 8%
4、 HCG dynamic monitoring
Detection time HCG (mIU/ml) Progesterone (ng/ml) Clinical measures
10 days after transplantation 368 32.5 maintenance medication
12 days after transplantation 798 28.7 plus aspirin
14 days after transplantation 1652 25.3 reduced progesterone dosage
Pregnancy 5 weeks 18563 22.1 First ultrasound
5、 Full cost breakdown
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Project Amount (Yuan) Description
Preoperative examination 4860 including chromosome analysis
12350 Gonafene+Lirui for promoting ovulation
Surgical cost 8600 yuan for egg retrieval and transplantation
Laboratory operation 15000 including embryo freezing for 1 year
Frozen embryo management 3000 renewal for the following year
Medication (transplant cycle) 2480 Bu Jia Le+Progesterone
Total cost 46290 Medical insurance reimbursement 6820
6、 Key Technologies and Innovation Points
Tubal pre-treatment:
Laparoscopic proximal ligation (reducing the risk of water accumulation and reflux)
Optimization of emission promotion plan:
Adopting the "Step down" dose adjustment method (obtaining 16 eggs, OHSS risk level 0)
Embryo selection technology:
Dynamic scoring of time difference incubator (EmbryoScope+)
Metabolomics analysis of culture medium (selecting the most viable embryos)
7、 Pregnancy outcome tracking
12 weeks of pregnancy: NT 1.2mm, non-invasive DNA low-risk
24 weeks of pregnancy: normal major screening test
Delivery situation: 38+3 weeks of pregnancy, vaginal delivery, male infant 3150g, Apgar score 10
Remaining frozen embryos: 4 blastocysts (continue to be preserved)
8、 Expert in-depth review
Comment from the Director of the Reproductive Center:
The key to the success of this case lies in:
Precise control of ovulation induction dose (balance of egg quality and quantity)
A comprehensive fallopian tube treatment plan
Strict control of embryo culture environment (incubator O ₂ concentration of 5%)
Attention: Patients with tubal factors still need regular gynecological examinations even if the test tube is successful. "
9、 Patient Witness
From hydrosalpinx to successfully holding the baby, we are most grateful to the doctor for insisting on treating the hydrosalpinx first. Although we performed multiple surgeries, we avoided the risk of repeated failures. Now that the baby is 6 months old, there are still 4 frozen embryos waiting to give birth to his younger siblings
(Note: This case is from the excellent case library of the National Assisted Reproductive Technology Quality Control Center in 2024 and has been desensitized.)
10、 Extended knowledge
Reference for this case:
The impact of hydrosalpinx on IVF outcomes "(Fertil Sterling 2023)
Expert Consensus on the "Step down" Emission Promotion Plan (Reprod Biol 2024)
Technical update: Starting from 2024, our center will add an AI embryo rating system with a prediction accuracy rate of 91%
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