胚胎卵裂球损伤与继续发育对临床结果的影响

Effects of blastomeres damage and further development on clinical outcome

目的:比较玻璃化冷冻人卵裂期胚胎解冻后卵裂球损伤和继续发育对种植率以及临床妊娠率的影响。方法:选择在辅助生殖中心行181个卵裂期的FET周期进行研究。试验一根据复苏胚胎有无损伤和继续发育分为:A有损伤无发育,B无损伤有发育,C无损伤无发育,D有损伤有发育4组;试验二以B组无损伤有发育为基础,据移植继续发育胚胎数目分为:B1组1个胚胎继续发育,B2组2个胚胎继续发育,B3组3个胚胎继续发育,比较种植率以及临床妊娠率。结果:B组妊娠率、胚胎种植率高于A、C两组,差异有统计学意义(P<0.05);B3组妊娠率高于B1、B2两组,差异有统计学意义(P<0.05)。但胚胎种植率、多胎妊娠率各组间差异无统计学意义(P>0.05)。结论:解冻复苏胚胎继续培养后是否有进一步发育对预测临床妊娠较卵裂球是否损伤更有价值。

Objective： To compare the effects of blastomeres damage and further development on implantation rate and clinical pregnancy rate after vitrification during cleavage period. Methods： One hundred and eighty - one FET cycles during cleavage period from assisted reproductive center were researched. In the first study, the embryos were divided into group A （with injury and without development） , group B （without injury and with development）, group C （without injury and development）, and group D （with injury and development） according to thawed embryos with injury and further development or not ; in the second study, on the basis of without injury and with development in group B, the embryos were divided into B1 group （further development of one embryo） , B2 group （further development of two embryos） , and group B3 （further development of three embryos） according to the number of embryos with further development. The implantation rates and clinical pregnancy rates were compared. Results： The pregnancy rate and embryo implantation rate in group B were significantly higher than those in group A and group C （P 〈0. 05） . The pregnancy rate in B3 group was significantly higher than those in B1 group and B2 group （ P 〈 O. 05 ） . But there was no statistically significant difference in the embryo implantation rate and muhiple pregnancy rate among B1 group, B2 group, and B3 group （P 〉 0. 05 ） . Conclusion： Compared with blastomeres damage or not in FET cycles, further development or not after continuous culture of thawed embryos has higher value to predict clinical pregnancy.