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目的探讨人囊胚玻璃化冷冻-复苏后经体外培养后囊胚的复苏及体外培养时间对妊娠结局的影响。方法以冻融囊胚复苏后的162例为研究对象,根据解冻后不同培养时间分为2h移植组(A组,n=80)和次日(18h)移植组(B组,n=82);再根据囊胚的扩张情况(分1孵出、2完全扩张、3部分扩张、4无扩张),比较两组间的临床妊娠率和胚胎种植率的差异。结果 A组临床妊娠率和种植率分别为63.8%和43.5%,B组为49.38%和37.76%,组间差异无统计学意义(P>0.05);移植A1组临床妊娠率(90.0%)最高,但与A2组(63.6%)比较差异无统计学意义(P>0.05);A4组较低(33.3%),与A1、A2组比较有统计学差异(P<0.05)。B1组临床妊娠率(53.13%)与B2组(54.5%)比较差异无统计学意义(P>0.05);B3组最低(0%),与B1、B2组比较有统计学差异(P<0.05)。结论延长冻体外培养时间不能提高冻融囊胚移植周期的妊娠率和种植率,延长培养时间后,无扩张的囊胚发育潜能低.但可以通过观察复苏后囊胚的扩张情况评估其发育潜能,选择有发育潜能的囊胚进行移植。
Objective To investigate the effect of blastocyst resuscitation and in vitro culture on the outcome of pregnancy after human blastocyst vitrification-resuscitation. Methods According to the different culture time after thawing, 162 cases of frozen-thawed blastocyst resuscitation were divided into two groups (group A, n = 80) and the next day (group B, n = 82) ; And then according to the expansion of blastocysts (1 hatched, 2 fully expanded, 3 partially expanded, 4 no expansion), the difference between the clinical pregnancy rate and embryo implantation rate was compared between the two groups. Results The clinical pregnancy rate and implantation rate in group A were 63.8% and 43.5% respectively, while those in group B were 49.38% and 37.76%. There was no significant difference between groups (P> 0.05). The clinical pregnancy rate (90.0%) in group A1 was the highest (P <0.05), but there was no significant difference between the two groups (63.6%) (P> 0.05). The difference between the two groups was statistically significant (P <0.05). The clinical pregnancy rate in group B1 (53.13%) was not significantly different from that in group B2 (54.5%) (P> 0.05); the lowest in group B3 was 0%, which was significantly different from that in group B1 and B2 ). CONCLUSION: Prolonging the in vitro culture time can not improve the pregnancy rate and implantation rate of the frozen-thawed blastocysts, but the developmental potential of the non-expanding blastocysts is prolonged after prolonging the culture time, but the developmental potential can be evaluated by observing the expansion of the blastocyst after resuscitation , Select the development potential of blastocysts for transplantation.