{"id":5966,"date":"2019-04-02T14:53:52","date_gmt":"2019-04-02T07:53:52","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=5966"},"modified":"2019-04-02T14:53:52","modified_gmt":"2019-04-02T07:53:52","slug":"anh-huong-cua-hinh-thai-noan-len-ti-le-song-sau-ra-dong","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/anh-huong-cua-hinh-thai-noan-len-ti-le-song-sau-ra-dong\/","title":{"rendered":"\u1ea2nh h\u01b0\u1edfng c\u1ee7a h\u00ecnh th\u00e1i no\u00e3n l\u00ean t\u1ec9 l\u1ec7 s\u1ed1ng sau r\u00e3 \u0111\u00f4ng"},"content":{"rendered":"<h2>\u1ea2nh h\u01b0\u1edfng c\u1ee7a h\u00ecnh th\u00e1i no\u00e3n l\u00ean t\u1ec9 l\u1ec7 s\u1ed1ng sau r\u00e3 \u0111\u00f4ng v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u00f4i \u1edf nh\u1eefng no\u00e3n t\u1ef1 th\u00e2n tr\u1eef l\u1ea1nh b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a.<\/h2>\n<p>Th.S. Nguy\u1ec5n H\u1eefu Duy \u2013 chuy\u00ean vi\u00ean ph\u00f4i h\u1ecdc \u2013 IVF V\u1ea1n H\u1ea1nh<\/p>\n<p><strong>Ti\u1ec1m n\u0103ng ph\u00e1t tri\u1ec3n c\u1ee7a ph\u00f4i m\u1ed9t ph\u1ea7n \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh b\u1edfi ch\u1ea5t l\u01b0\u1ee3ng no\u00e3n<\/strong>. Th\u00f4ng th\u01b0\u1eddng, ch\u1ea5t l\u01b0\u1ee3ng no\u00e3n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 ch\u1ee7 y\u1ebfu d\u1ef1a tr\u00ean c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m h\u00ecnh th\u00e1i b\u00ean ngo\u00e0i. Trong th\u1ee5 tinh trong \u1ed1ng nghi\u1ec7m, c\u00f3 kho\u1ea3ng 60 &#8211; 70% no\u00e3n sau ch\u1ecdc h\u00fat c\u00f3 mang \u00edt nh\u1ea5t m\u1ed9t \u0111\u1eb7c \u0111i\u1ec3m b\u1ea5t th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i. Nh\u1eefng b\u1ea5t th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e2n th\u00e0nh 2 lo\u1ea1i l\u00e0 b\u00ean trong t\u1ebf b\u00e0o ch\u1ea5t (v\u00ed d\u1ee5: kh\u00f4ng b\u00e0o, th\u1ec3 v\u00f9i, m\u1ea1ng l\u01b0\u1edbi n\u1ed9i ch\u1ea5t tr\u01a1n, \u0111\u1ed9 m\u1ecbn b\u00e0o t\u01b0\u01a1ng), v\u00e0 b\u00ean ngo\u00e0i t\u1ebf b\u00e0o ch\u1ea5t (v\u00ed d\u1ee5: c\u00e1c b\u1ea5t th\u01b0\u1eddng \u1edf m\u00e0ng zona, PVS r\u1ed9ng, s\u1ef1 ph\u00e2n m\u1ea3nh th\u1ec3 c\u1ef1c v\u00e0 h\u00ecnh d\u1ea1ng no\u00e3n b\u1ea5t th\u01b0\u1eddng). Ng\u01b0\u1eddi ta cho r\u1eb1ng m\u1ed9t s\u1ed1 b\u1ea5t th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i c\u1ee7a no\u00e3n c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng ph\u00e1t tri\u1ec3n v\u00e0 ti\u1ec1m n\u0103ng l\u00e0m t\u1ed5 c\u1ee7a ph\u00f4i nh\u01b0ng \u1ea3nh h\u01b0\u1edfng c\u1ee7a ch\u00fang v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c k\u1ebft lu\u1eadn r\u00f5 r\u00e0ng.<\/p>\n<p>Tr\u1eef l\u1ea1nh no\u00e3n tr\u01b0\u1edbc \u0111\u00e2y l\u00e0 m\u1ed9t th\u00e1ch th\u1ee9c do kh\u00e1c v\u1edbi ph\u00f4i, no\u00e3n r\u1ea5t d\u1ec5 b\u1ecb t\u1ed5n th\u01b0\u01a1ng b\u1edfi qu\u00e1 tr\u00ecnh \u0111\u1ed9ng l\u1ea1nh \u2013 r\u00e3 \u0111\u00f4ng. Tuy nhi\u00ean, v\u1edbi s\u1ef1 ra \u0111\u1eddi c\u1ee7a k\u1ef9 thu\u1eadt tr\u1eef l\u1ea1nh b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a, tr\u1eef l\u1ea1nh no\u00e3n \u0111\u00e3 \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng ph\u1ed5 bi\u1ebfn v\u00e0 th\u01b0\u1eddng quy trong th\u1ee5 tinh trong \u1ed1ng nghi\u1ec7m. \u0110\u1ed1i v\u1edbi no\u00e3n c\u00f3 h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng, \u1ea3nh h\u01b0\u1edfng c\u1ee7a qu\u00e1 tr\u00ecnh th\u1ee7y tinh h\u00f3a v\u1eabn l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 ch\u01b0a \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft. S\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a c\u00e1c ki\u1ec3u b\u1ea5t th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a c\u00e1c ch\u1ea5t b\u1ea3o v\u1ec7 \u0111\u00f4ng l\u1ea1nh (CPA) v\u00e0o no\u00e3n v\u00e0 do \u0111\u00f3 l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 h\u00ecnh th\u00e0nh tr\u1ea1ng th\u00e1i th\u1ee7y tinh h\u00f3a c\u1ea7n thi\u1ebft cho s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a k\u1ef9 thu\u1eadt th\u1ee7y tinh h\u00f3a. Ngo\u00e0i ra, ng\u01b0\u1eddi ta c\u0169ng kh\u00f4ng bi\u1ebft li\u1ec7u qu\u00e1 tr\u00ecnh th\u1ee7y tinh h\u00f3a c\u00f3 th\u1ec3 \u0111\u00f3ng vai tr\u00f2 nh\u01b0 m\u1ed9t y\u1ebfu t\u1ed1 b\u00ean ngo\u00e0i c\u00f3 th\u1ec3 thay \u0111\u1ed5i c\u00e1c t\u00e1c \u0111\u1ed9ng ti\u1ec1m t\u00e0ng n\u1ebfu c\u00f3 c\u1ee7a c\u00e1c b\u1ea5t th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i. Do \u0111\u00f3, t\u00e1c gi\u1ea3 Aila Coello v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 ti\u1ebfn h\u00e0nh nghi\u00ean c\u1ee9u v\u1edbi m\u1ee5c \u0111\u00edch \u0111\u00e1nh gi\u00e1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a c\u00e1c ki\u1ec3u b\u1ea5t th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i no\u00e3n \u0111\u1ebfn t\u1ec9 l\u1ec7 s\u1ed1ng sau r\u00e3 \u0111\u00f4ng, s\u1ef1 th\u1ee5 tinh v\u00e0 ph\u00e1t tri\u1ec3n ph\u00f4i \u1edf c\u00e1c no\u00e3n t\u1ef1 th\u00e2n \u0111\u00f4ng l\u1ea1nh b\u1eb1ng k\u1ef9 thu\u1eadt th\u1ee7y tinh h\u00f3a. Ngo\u00e0i ra, nh\u00f3m nghi\u00ean c\u1ee9u c\u0169ng ph\u00e2n t\u00edch \u1ea3nh h\u01b0\u1edfng c\u1ee7a lo\u1ea1i v\u00e0 s\u1ed1 l\u01b0\u1ee3ng b\u1ea5t th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i tr\u00ean c\u00e1c bi\u1ebfn tr\u00ean.<\/p>\n<p>\u0110\u00e2y l\u00e0 m\u1ed9t nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u t\u1eeb th\u00e1ng 12-2011 \u0111\u1ebfn th\u00e1ng 10-2016, so s\u00e1nh t\u1ef7 l\u1ec7 s\u1ed1ng, t\u1ec9 l\u1ec7 th\u1ee5 tinh v\u00e0 t\u1ec9 l\u1ec7 ph\u00e1t tri\u1ec3n ph\u00f4i sau r\u00e3 \u0111\u00f4ng gi\u1eefa no\u00e3n c\u00f3 h\u00ecnh th\u00e1i b\u00ecnh th\u01b0\u1eddng (n = 269) v\u00e0 no\u00e3n c\u00f3 h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng (n = 147). C\u00e1c no\u00e3n b\u1ea5t th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i \u0111\u01b0\u1ee3c ch\u1ee5p h\u00ecnh tr\u01b0\u1edbc l\u00fac tr\u1eef l\u1ea1nh v\u00e0 sau khi r\u00e3 \u0111\u00f4ng \u0111\u1ec3 so s\u00e1nh.<\/p>\n<p>K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y t\u1ef7 l\u1ec7 s\u1ed1ng sau r\u00e3 \u0111\u00f4ng l\u00e0 81,4% \u1edf nh\u00f3m no\u00e3n h\u00ecnh th\u00e1i b\u00ecnh th\u01b0\u1eddng v\u00e0 87,1% \u1edf nh\u00f3m no\u00e3n h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng (OR 1,53; 95%, kho\u1ea3ng tin c\u1eady 0,86 \u0111\u1ebfn 2,72). Nh\u00f3m no\u00e3n h\u00ecnh th\u00e1i b\u00ecnh th\u01b0\u1eddng v\u00e0 nh\u00f3m no\u00e3n h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng l\u1ea7n l\u01b0\u1ee3t c\u00f3 t\u1ef7 l\u1ec7 th\u1ee5 tinh l\u00e0 69,9% so v\u1edbi 66,4% (OR 0,85; 95%, kho\u1ea3ng tin c\u1eady 0,53 \u0111\u1ebfn 1,36), t\u1ef7 l\u1ec7 ph\u00f4i ch\u1ea5t l\u01b0\u1ee3ng t\u1ed1t v\u00e0o ng\u00e0y 3 l\u00e0 30,3% so v\u1edbi 32,0% (OR 1,08; 95%, kho\u1ea3ng tin c\u1eady 0,59 \u0111\u1ebfn 1,97) v\u00e0 t\u1ef7 l\u1ec7 h\u00ecnh th\u00e0nh ph\u00f4i nang l\u00e0 54,5% so v\u1edbi 60,5% (OR 1,27; 95%, kho\u1ea3ng tin c\u1eady 0,60 \u0111\u1ebfn 2,72). C\u00e1c s\u1ef1 kh\u00e1c bi\u1ec7t tr\u00ean \u0111\u1ec1u kh\u00f4ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea. Lo\u1ea1i h\u00ecnh th\u00e1i no\u00e3n b\u1ea5t th\u01b0\u1eddng ph\u1ed5 bi\u1ebfn trong nghi\u00ean c\u1ee9u l\u00e0 b\u00e0o t\u01b0\u01a1ng h\u1ea1t v\u00f9ng trung t\u00e2m t\u1ebf b\u00e0o ch\u1ea5t (CLG) (40,8%) v\u00e0 m\u00e0ng ZP b\u1ea5t th\u01b0\u1eddng (38,8%). Kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea \u0111\u1ed1i v\u1edbi s\u1ed1 l\u01b0\u1ee3ng (m\u1ed9t b\u1ea5t th\u01b0\u1eddng so v\u1edbi nhi\u1ec1u b\u1ea5t th\u01b0\u1eddng tr\u00ean m\u1ed9t no\u00e3n) v\u00e0 lo\u1ea1i h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng (b\u00ean ngo\u00e0i t\u1ebf b\u00e0o ch\u1ea5t so v\u1edbi b\u00ean trong t\u1ebf b\u00e0o ch\u1ea5t) \u0111\u01b0\u1ee3c ph\u00e2n t\u00edch. Ngo\u00e0i ra, khi ph\u00e2n t\u00edch c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y nhi\u1ec5u nh\u01b0 tu\u1ed5i v\u1ee3, BMI, th\u1eddi gian k\u00edch th\u00edch bu\u1ed3ng tr\u1ee9ng, n\u1ed3ng \u0111\u1ed9 E2 ng\u00e0y ti\u00eam hCG, th\u1eddi gian tr\u1eef l\u1ea1nh, nh\u00f3m nghi\u00ean c\u1ee9u kh\u00f4ng th\u1ea5y c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 nhi\u1ec5u n\u00e0y l\u00ean t\u1ec9 l\u1ec7 s\u1ed1ng sau r\u00e3 \u0111\u00f4ng c\u1ee7a no\u00e3n h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng. H\u1ea1n ch\u1ebf c\u1ee7a nghi\u00ean c\u1ee9u l\u00e0 kh\u00f4ng ph\u00e2n t\u00edch ri\u00eang t\u1eebng lo\u1ea1i h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng no\u00e3n, ch\u1ec9 \u0111\u00e1nh gi\u00e1 \u1edf m\u1ee9c \u0111\u1ed9 ph\u00f4i, kh\u00f4ng \u0111\u00e1nh gi\u00e1 y\u1ebfu t\u1ed1 tr\u1ebb sinh s\u1ed1ng \u1edf c\u00e1c tr\u01b0\u1eddng h\u1ee3p no\u00e3n c\u00f3 h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng.<\/p>\n<p>T\u00f3m l\u1ea1i, k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u n\u00e0y cho th\u1ea5y khi tr\u1eef l\u1ea1nh c\u00e1c no\u00e3n h\u00ecnh th\u00e1i b\u1ea5t th\u01b0\u1eddng d\u01b0\u1eddng nh\u01b0 kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c k\u1ebft qu\u1ea3 sau r\u00e3 \u0111\u00f4ng nh\u01b0 t\u1ec9 l\u1ec7 s\u1ed1ng s\u00f3t, s\u1ef1 th\u1ee5 tinh v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u00f4i c\u0169ng nh\u01b0 cho k\u1ebft qu\u1ea3 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi c\u00e1c no\u00e3n b\u00ecnh th\u01b0\u1eddng v\u1ec1 h\u00ecnh th\u00e1i.<\/p>\n<p>Ngu\u1ed3n: Effect of oocyte morphology on post-warming survival and embryo development in vitrified autologous oocytes.<br \/>\nCoello, Aila et al. Reproductive BioMedicine Online, Volume 38, Issue 3, 313 &#8211; 320 Link\u00a0<a href=\"https:\/\/www.rbmojournal.com\/article\/S1472-6483(19)30007-0\/abstract\" rel=\"noopener\">https:\/\/www.rbmojournal.com\/article\/S1472-6483(19)30007-0\/abstract<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u1ea2nh h\u01b0\u1edfng c\u1ee7a h\u00ecnh th\u00e1i no\u00e3n l\u00ean t\u1ec9 l\u1ec7 s\u1ed1ng sau r\u00e3 \u0111\u00f4ng v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u00f4i \u1edf nh\u1eefng no\u00e3n t\u1ef1 th\u00e2n tr\u1eef l\u1ea1nh b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a. Th.S. Nguy\u1ec5n H\u1eefu Duy \u2013 chuy\u00ean vi\u00ean ph\u00f4i h\u1ecdc \u2013 IVF V\u1ea1n H\u1ea1nh Ti\u1ec1m n\u0103ng ph\u00e1t tri\u1ec3n c\u1ee7a ph\u00f4i m\u1ed9t ph\u1ea7n \u0111\u01b0\u1ee3c quy\u1ebft [&#8230;]\n","protected":false},"author":1,"featured_media":5967,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5966","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5966","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=5966"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5966\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5967"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5966"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5966"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5966"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}