慢速程序化冷冻与玻璃化冷冻对第3天分裂期胚胎发育潜能的影响

Comparison of vitrification and slow-freezing of human day 3 cleavage stage embryos:postvitrification development and pregnancy outcomes

目的比较慢速程序化冷冻法(慢速法)和玻璃化冷冻法(玻璃化法)对第3天分裂期胚胎发育潜能的影响。方法选择因输卵管阻塞或男性少弱精因素行体外受精(IVF)或卵母细胞胞质内单精子注射(ICSI)治疗的患者,挑选在行 IVF 或 ICSI 后第3天剩余优质胚胎数目超过4个者80例进入本研究。随机将每例患者的2个胚胎用玻璃化法冷冻,另外2个用慢速法冷冻;冷冻复苏后随机抽取40例患者移植慢速法冷冻的胚胎,另40例患者移植玻璃化法冷冻的胚胎,比较2种冷冻方法对胚胎发育潜能的影响。结果冷冻复苏后待移植的胚胎共160个,其中慢速法冷冻80个,复苏后存活73个(91%,73/80),移植后40例患者中15例(38%,15/40)获得临床妊娠,其中3例(20%,3/15)为双胎妊娠,余为单胎妊娠,胚胎着床率为25%(18/73);玻璃化法冷冻胚胎80个,复苏后存活71个(89%,71/80)。移植后40例患者中19例(48%,19/40)获得临床妊娠,其中9例(47%,9/19)为双胎妊娠,余为单胎妊娠,胚胎着床率为39%(28/71),与慢速法相比,玻璃化法的临床妊娠率和双胎妊娠率均有提高,但差异无统计学意义(P>0.05),而胚胎着床率则显著提高,差异有统计学意义(P<0.05)。结论玻璃化法能够更好地保存胚胎复苏后的发育潜能,更适合第3天分裂期胚胎的冷冻保存。

Objective To compare the effects of vitrification with slow-freezing on the developmental ability of day 3 cleavage stage embryos. Methods Patients who had no less than 4 high quality embryos were included in this study. These embryos were eryopreserved using the methods of vitrification or slow-freezing. In the eryopreserved embryo transfer cycles, the embryos which were eryopreserved using one of the methods were chosen randomly. The developmental ability of embryos was compared between these two groups. Results A total of 80 patients were included in this study with 160 embryos. In the group of slow-freezing, 73 （91%） embryos were survived and achieved 15（38% ） clinical pregnancies. Among these, 3 were twins and the implantation rate was 25% （18/73）. In the group of vitrification, 71 （ 89% ） embryos were survived and achieved 19 （48%） clinical pregnancies. Among these, 9 were twins and the implantation rate was 39% （28/71）, which was significantly higher than the slow-freezing group （P 〈 0. 05 ）. Otherwise, the clinical pregnant rate and multiple pregnant rate was higher in the group of vitrification than the slow-freezing group, but had no significance. Conclusion Vitrification is more benefit for the developmental ability of the thawed embryos and more suitable for the eryopreservation of day 3 cleavage stage embryos.