目的:探讨胚胎冷冻复苏后,卵裂球存活状态对胚胎发育的影响以及体外授精(IVF)和卵胞质内单精子注射(ICSI)2种授精方式对冷冻胚胎复苏后体外发育能力和妊娠结局的影响。方法:回顾性分析142例患者,150个复苏周期,共769个冷冻胚胎复苏后培养至囊胚期进行移植的结果。结果:共复苏胚胎769个,存活胚胎702个,复苏率91.3%。220个胚胎(31%)到达囊胚阶段。在卵裂球全部存活胚胎中,囊胚形成率35%,部分存活胚胎中囊胚形成率24%,两者有统计学差异(P<0.01)。在卵裂球全部存活胚胎中,来源于IVF的胚胎囊胚形成率为40%,来源于ICSI的为26%,两者有统计学差异(P<0.01);部分卵裂球存活胚胎中来源于IVF的胚胎囊胚形成率为26%,来源于ICSI的为19%,差异无统计学意义(P>0.05)。在全部220个囊胚中,IVF组的优质囊胚率为38.6%,ICSI组的优质囊胚率为21.0%,差异有统计学意义(P<0.05)。临床妊娠率IVF组和ICSI组分别为61.05%与61.11%;胚胎种植率分别为37.50%与36.67%,活产率分别为81.03%与78.79%,差异均无统计学意义(P>0.05)。结论:胚胎冷冻复苏后卵裂球的损伤削弱了囊胚形成能力,影响卵裂期胚胎进一步发育,这与ICSI和冷冻胚胎复苏后发育潜能的降低有关,但其对临床结果和妊娠结局的影响不大。 OBJECTIVE: To investigate the effect of blastocyst survival on embryonic development and the effects of IVF and ICSI on the developmental competence and pregnancy outcome of frozen embryos after resuscitation influences. Methods: A total of 142 patients and 150 cycles of resuscitation were retrospectively analyzed. A total of 769 frozen embryos were resuscitated and then cultured to blastula stage for transplantation. Results: A total of 769 embryos were recovered and 702 survived embryos, the recovery rate was 91.3%. 220 embryos (31%) reached the blastocyst stage. The blastocyst formation rate was 35% and the blastocyst formation rate was 24% in some surviving embryos. The difference was statistically significant (P <0.01). Among all the surviving blastomeres, embryo blastocyst formation rate from IVF was 40%, derived from ICSI was 26%, there was a significant difference between the two (P <0.01) The embryo blastocyst formation rate was 26% in IVF and 19% in ICSI, the difference was not statistically significant (P> 0.05). Among all 220 blastocysts, the high-quality blastocyst rate was 38.6% in IVF group and 21.0% in ICSI group, with significant difference (P <0.05). The clinical pregnancy rates were 61.05% and 61.11% in the IVF and ICSI groups, respectively. The embryo implantation rates were 37.50% and 36.67% respectively, and the live birth rates were 81.03% and 78.79%, respectively. There was no significant difference between the two groups (P> 0.05). CONCLUSIONS: The blastomere injury attenuates blastula formation and affects further development of cleavage stage embryos following cryoablation of embryos, which is associated with reduced developmental potential after ICSI and frozen embryo resuscitation but its effect on clinical outcome and pregnancy outcome Not big.