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目的:探讨人卵裂期胚胎玻璃化冷冻-复苏后体外培养时间对妊娠结局的影响。方法:回顾性分析623例冻融胚胎移植(FET)周期的资料,根据解冻后不同移植时间分为当日移植组(A组,n=307)和次日移植组(B组,n=316);再根据卵裂球的生长与否将B组分为全部生长(B1组,n=184),部分生长(B2组,n=101)和均无生长(B3组,n=31)3组。比较各组间的临床妊娠率和胚胎种植率。结果:A组临床妊娠率和种植率分别为36.2%和19.6%,B组为38.3%和20.1%,组间差异无统计学意义(P>0.05);次日移植的B1组临床妊娠率和种植率(41.8%和23.4%)最高,但与B2组(39.6%和22.8%)比较差异无统计学意义(P>0.05);B3组最低(12.9%和5.4%),与B1、B2组比较有统计学差异(P<0.01)。结论:延长冻融胚胎体外培养时间不能显著提高冻融胚胎移植周期的妊娠率和种植率,延长培养时间后,无生长的胚胎发育潜能低。因此可以通过观察复苏后胚胎的生长情况评估其发育潜能,选择优质的胚胎进行移植。
Objective: To investigate the effect of vitrification-resuscitation in vitro on the pregnancy outcome of human cleavage stage embryos. Methods: The data of 623 cycles of frozen-thawed embryo transfer (FET) were retrospectively analyzed. According to the different transplantation time after thawing, the data were divided into day transplantation group (n = 307) and second day transplantation group (n = 316) (Group B1, n = 184), partial growth (group B2, n = 101) and group B without growth (group B3, n = 31) according to the growth of blastomeres . The clinical pregnancy rate and embryo implantation rate were compared between groups. Results: The clinical pregnancy rate and implantation rate in group A were 36.2% and 19.6% respectively, while in group B 38.3% and 20.1%, there was no significant difference between the two groups (P> 0.05) (41.8% and 23.4%) were the highest, but there was no significant difference compared with B2 (39.6% and 22.8%) (P> 0.05) There was a statistically significant difference (P <0.01). CONCLUSION: Prolonging the in vitro culture time of freeze-thawed embryos can not significantly increase the pregnancy rate and implantation rate of the frozen-thawed embryo transfer cycle. After prolonged culture, the embryonic developmental potential is low. Therefore, by observing the growth of embryos after resuscitation assessment of their developmental potential, selection of high quality embryos for transplantation.