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目的:探讨激光打孔使囊胚腔皱缩在体外受精周期囊胚玻璃化冷冻中的应用价值。方法:将常规取卵后第3日移植、冷冻后剩余的形态学评分较差的胚胎发育而来的囊胚,采用或不采用激光打孔使囊胚腔皱缩后冷冻。分析606例解冻囊胚周期,比较采用和未采用激光皱缩2种方法冻存囊胚的效率,分析激光皱缩在囊胚玻璃化冷冻中的价值。结果:激光皱缩组解冻247例,4例(1.62%)取消移植,移植243例;未皱缩组359例,24例(6.69%)取消移植,移植335例。移植患者的年龄、不孕原因、排卵日内膜厚度、平均移植胚胎数组间均无统计学差异(P>0.05)。激光皱缩组冻融取消率和流产率均显著低于非皱缩组(P<0.05),生化妊娠率(45.68%vs 35.82%)、种植率(22.54%vs 16.56%)和继续妊娠率(87.50%vs 75.56%)显著高于非皱缩组(P<0.05),临床妊娠率激光皱缩组略高于非皱缩组(32.92%vs 26.87%),但无统计学差异(P>0.05)。结论:囊胚冷冻前采用激光打孔皱缩可提高解冻后的胚胎存活率,并能显著降低流产率。
Objective: To investigate the application of laser drilling to collapse of the blastocyst in vitrification of in vitro fertilization cycle blastocysts. Methods: The blastocysts derived from embryos that were transplanted on day 3 after conventional ovulation and those with poor morphology score after freezing were cryopreserved with or without laser drilling. The blastocyst cycle was analyzed in 606 cases. The efficiency of cryopreservation of blastocysts with and without laser shrinkage was compared. The value of laser shrinkage in blastocyst vitrification was analyzed. Results: There were 247 cases thawed in the laser shrinkage group, and 243 cases were canceled and transplanted in 4 cases (1.62%). There were 359 cases unwrinkled and 24 cases (6.69%) canceled the transplantation and 335 cases were transplanted. There were no significant differences in the age of transplant patients, the causes of infertility, the endometrial thickness on ovulation day, and the average number of transplanted embryos (P> 0.05). The rates of ablation and abortion of laser shrinkage group were significantly lower than those of non-shrinkage group (P <0.05), biochemical pregnancy rate (45.68% vs 35.82%), implantation rate (22.54% vs 16.56% 87.50% vs 75.56%) was significantly higher than that of the non-shrinkage group (P <0.05). The clinical pregnancy rate was slightly higher in the non-shrinkage group (32.92% vs 26.87% ). Conclusion: The pre-freezing cryopreservation of embryos can increase the survival rate of embryos after thawing and significantly reduce the abortion rate.