不同冷冻方案对人早期胚胎发育潜能的影响

Effects of different cryopreservation methods on developmental potential of early human embryo

目的:比较开放式、封闭式玻璃化冷冻技术及程序化慢速冷冻法对辅助生殖技术人早期胚胎冷冻复苏的效果。方法:回顾性分析622例胚胎冷冻复苏资料,将体外受精-胚胎移植(IVF-ET)患者第3天需要冷冻的胚胎,分别采用开放式、封闭式麦管玻璃化法及程序化慢速冷冻法冷冻,比较3组胚胎复苏率、空泡出现率、胚胎完整率、植入率、临床妊娠率、周期取消率、胚胎丢失率及流产率。结果:开放式冻存组共复苏280个周期、627个胚胎,胚胎复苏率、胚胎完整率、植入率和临床妊娠率分别为97.13%、94.89%、28.90%、52.61%,与程序化冷冻组(复苏165个周期、477个胚胎)胚胎复苏率(73.79%)、胚胎完整率(70.02%)、植入率(16.75%)和临床妊娠率(35.44%)相比差异有统计学意义(P<0.05),与封闭式冻存组(复苏177个周期、400个胚胎)相比差异均无统计学意义(P>0.05),3种冷冻组空泡出现率、周期取消率、胚胎丢失率及流产率差异均无统计学意义(P>0.05)。结论:两种玻璃化冷冻法能获得同样的冷冻效率,且均优于程序化冷冻法;封闭式麦管玻璃化法能更好地保存胚胎复苏后的发育潜能,是冻存人早期胚胎较为理想的方法。

Objective： To compare the effects of open vitrification method, closed vitrification method, and procedural slow - freezing method on recovery of early frozen human embryo in assisted reproductive technology. Methods ： The data of 622 cases with frozen and recovery embryo were analyzed retrospectively, the embryos on the third day during in vitro fertilization and embryo transfer （IVF -ET） were frozen by open vitrification method, closed vitrification method, and procedural slow - freezing method; the embryo recovery rates, vac- uole occurrence rates, embryo complete rates, embryo implantation rates, clinical pregnancy rates, cycle cancellation rates, embryo loss rates, and abortion rates in the three groups were compared. Results： A total of 280 cycles and 627 embryos were resurrected in open vitrifi- cation group; the embryo recovery rate, embryo complete rate, embryo implantation rate, and clinical pregnancy rate were 97. 13%, 94. 89%, 28.90%, amt 52. 61%, respectively, compared with procedural slow- freezing group （165 cycles and 477 embryos; 73.79%, 70.02% , 16. 75% , and 35.44% ） , there were statistically significant differences （ P 〈 0. 05 ） , compared with closed vitrification group （ 177 cycles and 400 embryos）, there was no statistically significant difference （P 〉 0. 05 ） ; there was no statistically significant difference in the vacuole occurrence rate, cycle cancellation rate, embryo loss rate, and abortion rate among the three groups （ P 〉 0. 05 ） . Conclusion ： Both open vitrification method and closed vitrification method can achieve the same cryopreservation efficiency, and the effects were superior to procedural slow - freezing method ; closed straw vitrification method can preserve developmental potential of embryo after recovery in an e- ven better fashion, which is a relatively ideal method for eryopreservation of early human embryo.