辅助孵化与培养时间对冻融胚胎移植结局的影响

Effects of different culture time and laser-assisted hatching on clinical outcome in frozen-thawed embryo transfer cycles

目的分析胚胎冻融后体外培养时间以及采用激光辅助孵化(AH)技术对临床妊娠率的影响。方法126名患者,130个冻融胚胎移植周期,按照是否实施AH技术分为AH组和非AH组,又按胚胎解冻后的不同培养时间进一步将两者分为2h(A/A’组)、1d(B/B’组)及2d组(C/C’组)。冻融胚胎采用慢速冷冻-快速解冻方法。冻融后的胚胎均置囊胚培养液培养2h、1d或2d,自1.48μm双极二氧化碳激光系统(ZILOS-tk)安装后的冻融胚胎均施行AH技术。结果AH组培养2h、1d、2d三组临床妊娠率之间有显著性差异(P<0.05);在培养1d与2d组中,实施AH与非AH组的临床妊娠率之间亦有显著性差异(P<0.05)。结论应用激光AH技术以及胚胎冻融后培养至桑椹胚或囊胚时行胚胎移植均显著提高冻融胚胎移植的临床妊娠率。

Objective： To analyze the influence of laser-assisted-hatching and culture time of embryos after thawing on clinical pregnancy rates in frozen-thawed embryo transfer （F-ET） cycles. Methods： One hundred and twenty-six patients were included in this study and a total of 130 F-ET cycles studied. They were divided into assisted hatching group and non-assisted hatching group, and these two groups were further divided into 2 h group （group A/A＇）, 1 d group （group B/B＇） and 2 d group （group C/C＇） according to the culture time after embryo thawing. Embryos from conventional slow-freezing and rapid-thawing protocols were cultured for 2 hours or lday or 2 clays before transferred. Assisted hatching was performed using 1.48 μm ambipolar carbon dioxide laser system . Results： In assisted-hatching group, the clinical pregnancy rate of group C was significantly higher than that of group A and group B （P〈0. 05）. Meanwhile, the group B and C of assisted-hatching group had significantly higher pregnancy rates than their non-assisted hatching counterparts. Conclusion： Development of the frozen-thawed embryos to blastocyst stage in vitro and application of laser-assisted hatching can improve the pregnancy rates in frozen-thawed embryo transfer cycles.