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目的:探讨激光透明带打孔法辅助孵化(AH)对玻璃化冻融胚胎/囊胚移植临床结局的影响。方法:选取该院生殖中心2012年9月~2014年3月进行的符合相关标准的D3日玻璃化冻融胚胎968周期和D5/D6日玻璃化冻融囊胚284周期资料。根据移植术前是否对胚胎/囊胚进行AH操作,将D3日冻融胚胎移植周期分为A1组(AH组,887周期)和A2组(未做AH组,81周期),D5/D6日冻融囊胚移植周期分为B1组(AH组,112周期)和B2组(未做AH组,172周期)。观察各组患者的胚胎种植率、临床妊娠率、早期流产率、多胎妊娠率、异位妊娠率等临床指标,分析AH对胚胎植入和妊娠结局的影响。结果:A1组/A2组、B1组/B2组间年龄、不孕年限、体重指数(BMI)、不孕因素、获卵数、内膜厚度、内膜准备方案等基础资料的比较,差异均无统计学意义(P>0.05);A1组/A2组、B1组/B2组间移植胚胎/囊胚数、植入优胚/囊胚比例、胚胎种植率、临床妊娠率、早期流产率、多胎妊娠率等指标的比较,差异也均无统计学意义(P>0.05)。结论:对玻璃化冻融胚胎移植和冻融囊胚移植,AH均未见到对胚胎植入和临床妊娠有显著影响。
Objective: To investigate the effect of laser zona pellucida-assisted hatching (AH) on the clinical outcome of vitrified freeze-thaw embryo / blastocyst transplantation. METHODS: A total of 968 cycles of D3-D-DICR and 964 cycles of D4 / D6-DMR were performed from September 2012 to March 2014 in the hospital reproductive center. According to whether embryos / blastocysts were treated with AH prior to transplantation, D3 weeks of embryos were divided into A1 group (AH group, 887 cycles) and A2 group (AH group, 81 cycles), D5 / D6 The cycles of freeze-thaw blastocyst transfer were divided into B1 group (AH group, 112 cycles) and B2 group (AH group, 172 cycles). The clinical indexes including embryo implantation rate, clinical pregnancy rate, early miscarriage rate, multiple pregnancy rate and ectopic pregnancy rate were observed. The effects of AH on embryo implantation and pregnancy outcome were analyzed. Results: The differences of age, age of infertility, body mass index (BMI), infertility, number of oocytes retrieved, thickness of endometrium, and preparation plan of endometrium between groups A1 and A2 and groups B1 and B2 There was no significant difference between the two groups (P> 0.05). The number of embryos / blastocysts in A1 group / A2 group, B1 group / B2 group, the ratio of excellent embryo / blastocyst implantation, embryo implantation rate, clinical pregnancy rate, Multiple pregnancy rates and other indicators of the comparison, the difference was not statistically significant (P> 0.05). CONCLUSION: There was no significant effect of embryo implantation and clinical pregnancy on the vitrified freeze-thawed embryo transfer and frozen-thawed blastocyst transplantation.