玻璃化冻融胚胎移植结局的相关影响因素

Factors influencing the outcomes of the vitrified frozen-thawed embryo transfer

背景:由于玻璃化冷冻在国内尚未大规模应用到临床,故关于影响玻璃化冻融胚胎移植结局的相关因素尚无定论。目的:探讨辅助生殖技术中影响玻璃化冻融胚胎移植结局的相关因素。方法:对2009-01/10在武汉大学人民医院生殖医学中心接受冷冻胚胎移植的142例患者154个周期的相关资料进行回顾性统计学分析,根据患者年龄、胚胎发育时期、受精方式、子宫内膜准备方案、移植日子宫内膜厚度、移植过程是否顺利和胚胎解冻复苏后成活细胞比例进行分组,比较各类分组的胚胎种植率和临床妊娠率。结果与结论:不同年龄、受精方式、子宫内膜准备方案、子宫内膜厚度和移植过程是否顺利组间胚胎种植率及临床妊娠率差异无显著性意义(P>0.05)。受精第2天的胚胎冻融组和受精第3天的胚胎冻融组的临床妊娠率差异无显著性意义(P>0.05),但受精第3天的胚胎冻融组的胚胎种植率明显高于受精第2天的胚胎冻融组(P<0.05)。胚胎复苏后成活细胞比例对胚胎种植率和临床妊娠率有明显影响(P<0.05)。在冻融胚胎移植周期,解冻后胚胎质量对妊娠的成功率起主要作用,准备适宜的子宫内膜厚度能提高临床妊娠率。

BACKGROUND：Considerable debate exists which factors influence the outcomes of the vitrified frozen-thawed embryo transfer because lack of clinical applications.OBJECTIVE：To explore the factors influencing the outcomes of the vitrified frozen-thawed embryo transfer in assisted reproductive technology.METHODS：A retrospective statistical analysis was performed in Reproductive Medicine Center,Renmin Hospital of Wuhan University of 142 patients,154 thawing cycles.The patients were grouped according to the age of patients,embryonic development,fertilization methods,endometrial preparation programs,the endometrial thickness,the process of transplantation and the survival cell ratio of embryo recovery,the implantation rate and clinical pregnancy rate were compared between various groups.RESULTS AND CONCLUSION：Among the groups of the different age,fertilization methods,endometrial preparation programs,endometrial thickness and the process of embryo transfer embryo implantation rate and clinical pregnancy rate were no significant difference（P 0.05）;between the two groups of the second day fertilized embryos（D2）and the third day（D3）fertilized embryos,the clinical pregnancy rate was not significant（P 0.05）,but the embryo implantation rate of D3 group was significantly higher than D2 group.The survival cell ratio of embryo recovery has a significant effect on implantation rate and clinical pregnancy rate（P 0.05）.In the frozen-thawed embryo transfer cycles,embryo quality plays a major role in pregnancy rate,and preparation for appropriate endometrial thickness can improve the clinical pregnancy rate.