玻璃化冷冻后首次复苏移植卵裂期与囊胚期的妊娠结局比较

Comparison of Pregnancy Results between the Cleavage Stage and the Blastocyst Stage for the First Resuscitation after Vitrification

目的:将玻璃化冷冻后首次复苏移植卵裂期胚胎与首次复苏囊胚期胚胎妊娠结局进行比较。方法:对2018年5月—2019年8月在我院行体外受精/卵胞浆内单精子注射手术(IVF/ICSI)助孕病例进行分析,行玻璃化冷冻后首次复苏移植共272例,根据胚胎发育期将其分为卵裂组和囊胚组,其中卵裂组胚胎106例,囊胚组胚胎166例。比较两组间的妊娠情况及妊娠结局。结果:两组间年龄、体重指数、不孕年限、HCG内膜厚度等比较均无统计学差异(P>0.05),两组的平均移植数目差异有统计学意义(P<0.05)。囊胚组的妊娠率67.47%(112/166)、着床率59.90%(115/192),优于卵裂组的妊娠率55.66%(59/106)、着床率37.11%(77/208),囊胚组多胎率3.57%(4/112)低于卵裂组多胎率30.51%(18/59),差异均有统计学意义(P<0.05)。结论:玻璃化冷冻解冻操作下,复苏卵裂期胚胎和囊胚存活效果显著,均有较高的着床率与妊娠率,但囊胚组冷冻移植的临床妊娠结局优于胚胎组。

Objective:This study is aimed to compare the pregnancy results of the first resuscitation of vitrified cleavage embryos and the first resuscitation of vitrified blastocysts.Methods:A total of 272 who had the vitrification freeze-thaw transfer cycles under IVF/ICSI assisted pregnancy in the Reproductive Medicine Center of Peoples’Hospital of Qinghai from May 2018 to August 2019 were retrospectively analyzed,among which 106 were the first resuscitated embryo transfer cycles at the cleavage stage,and 166 cases were resuscitated the blastocyst transfer cycle for the first time.The recovery rate,pregnancy rate,implantation rate,miscarriage rate and multiple pregnancy rate were compared between the two groups.Results:There was no significant difference in age,infertility time,BMI,HCG intima thickness between the two groups without statistical significance(P>0.05),but the average number of embryos transferred was extremely significant(P<0.05).The resuscitation rate and abortion rate of the two groups were not significantly different(P>0.05).The ectopic pregnancy rate of the blastocyst group was lower than that of the cleavage group,but there was no statistical difference(P>0.05).The ectopic pregnancy rate of the blastocyst group was lower than that of the cleavage groupwithout statistical difference(P>0.05).The pregnancy rate of the blastocyst group was 67.47%(112/166),the implantation rate was 59.90%(115/192),and the multiple birth rate was 3.28%(4/112),which were better than the pregnancy rate of the cleavage group by 55.66%(59/106),the implantation rate 37.11%(77/208),and the multiple birth rate 30.51%(18/59),in which there were statistically significant(P<0.05).Conclusion:The Vitrification freezing and thawing is beneficial to the recovery of blastocysts and embryos in cleavage stage,which has a higher implantation rate and pregnancy rate,but the clinical outcome of frozen blastocyst stage was better than that of embryo group.