摘要
目的比较程序化和玻璃化冷冻保存人D2和D3胚胎的临床结局,分析探讨不同冷冻方法对人D2和D3胚胎冷冻的影响。方法回顾性分析了本中心170个D2和D3胚胎复苏周期,比较程序化和玻璃化冷冻复苏后的存活率、卵裂球存活指数、完胚率、≥1完胚移植率、种植率、临床妊娠率、流产率等指标。结果程序化解冻移植周期47个,存活率73.60%,卵裂球存活指数65.88%,完胚率31.46%,≥1完胚移植率80.85%,胚胎种植率14.17%,临床妊娠率36.17%,流产率11.76%。玻璃化解冻移植周期120个,存活率92.96%,卵裂球存活指数86.49%,完胚率68.04%,≥1完胚移植率90.83%,胚胎种植率18.84%,临床妊娠率35.83%,流产率9.30%。玻璃化冷冻比程序冷冻能显著提高胚胎存活率、卵裂球存活指数和完胚率(P<0.05),但在≥1完胚移植率、临床妊娠率、胚胎种植率和流产率上无显著性差异。无论采用哪种冷冻方法,D2和D3胚胎在所有统计指标上差异均没有显著意义。结论玻璃化冷冻是一种有效的冷冻方法,其复苏存活率、卵裂球存活指数和完胚率均明显高于程序化冷冻,可作为传统程序化冷冻的替代方法。D3胚胎冷冻没有比D2胚胎更有优势,对于工作量较大的IVF实验室可选择D2胚胎冷冻移植。
Objective To evaluate the efficacy of vitrification and slow freezing for the cryopreservation of haman day 2 and day 3 embryos in terms of post - warming clinical outcomes. Methods A retrospective study was performed by analyzing 170 frozen embryo thawed cycles with day 2 or day 3 embryos vitrified or slow - frozen. The main clinical outcomes were compared including survive rate, blastomere survival index, the proportion of transfers with at least one intact embryo, fully intact embryo per thawed embryos, implantation rate, pregnancy rate, miscarriage rate. Results Survival rate, blastomere survival index, the proportion of transfers with ≥ 1 intact embryo, fully intact embryo per thawed embryos, implantation rate, pregnancy rate, miscarriage rate were 73.6% , 65.88% , 80.85% , 31.46%, 14.17%, 36.17%, 11.76% in 47 slow-frozen transfer cycles and 92.96%, 86.49%, 90.83%, 68.04%, 18.84%, 35.83% , 9.30% in 120 vitrified transfer cycles,respectively. Vitrification provided a higher survival rate and blastomere survival index as well as fully intact embryo per thawed embryos, but it can not significantly improve the proportion of transfers with ≥ 1 intact embryo, fully intact embryo per thawed embryos, implantation rate, pregnancy rate, miscarriage rate. The results suggested that extending human embryO culture period from 2 to 3 days had no effect on the clinical outcomes. Conclusion Vitrification is an effective techniques for cryopreservation of human cleavage embryos that can be used as a substitute for programmed freezing. The survival rate, blastomere sur- vival index and fully intact embryo per thawed embryos are higher than those of traditional programmed frozen embryos. Freezing embryos on day 3 showed similar clinical results compared with day 2 cryopreservation. For a busy IVF （in vitro fertilization） laboratory, day 2 embryos can be frozen.
出处
《医学研究杂志》
2011年第3期44-48,共5页
Journal of Medical Research
基金
国家自然科学基金资助项目(81000244)
浙江省自然科学基金资助项目(Y2100058)
