程序化冷冻与玻璃化冷冻卵裂期胚胎移植的母婴结局对照分析

Comparison and analysis of the maternal and neonatal outcomes of programmed freezing and vitrification for cleavage stage embryo transfer

目的探讨分析程序化冷冻与玻璃化冷冻卵裂期胚胎复苏周期移植的母婴结局。方法对102例程序化冷冻复苏周期及109例玻璃化冷冻复苏周期进行回顾性分析,比较两组的临床结局及新生儿情况。结果两组患者的一般情况相似;程序化冷冻组和玻璃化冷冻组的胚胎复苏率分别为89.7%和99.6%(P<0.05),两组的临床妊娠率、着床率、活产率分别为56.6%、38.1%、79.2%和54.1%、33.3%、71.2%,差异无统计学意义(P>0.05);两组新生儿的孕周、出生体重、出生缺陷率无显著性差异(P>0.05),玻璃化冷冻组早产率(19.2%)有高于程序化冷冻组早产率(12.3%)的趋势,但无显著性差异(P>0.05)。结论玻璃化冷冻显著提高胚胎复苏率,能提高胚胎利用率,程序化冷冻组与玻璃化冷冻组相比拥有相似甚至更好的母婴结局,玻璃化冷冻在成为常规工作之前还需加强对其母婴结局的后续研究及子代的长期随访。

Objective. To compare pregnancy and neonatal outcomes between programmed freezing and vitrification. Methods： A retrospective study was performed to evaluate the clinical and infant outcomes of frozen embryo transfer（FET）cycles including 102 programmed freezing cycles and 109 vitrification cycles. Results： The embryos survival rate in vitrification group（99.6%）was significantly higher than that of programmed freezing group（89.7 %）（P〈0.05）. The clinical pregnant rate,implantation rate and live-birth rate were not significantly different between vitrification group （54.1%, 33.3% and 71.2%）and programmed freezing group（56.6% ,38. 1%, 79. 2%）（P〈0. 05）. There were also no significant differences in gestational weeks, weight and birth defect rate of infants between the two groups,though preterm birth rate of vitrification group（19.2%）was a little higher than that of programmed freezing group（12.3%）（P〉 0. 05）. Conclusions. Vitrification can significantly improve embryo usage rate by increasing the embryo survival rate. Comparing with vitrification group, programmed freezing group has similar or even better pregnancy and neonatal outcomes. Properly controlled and longer follow-up studies for neonatal outcome are needed before vitrification is used for routine.