体外培养时间对冻融囊胚移植结局的影响

Effects of different culture time on clinical outcome in frozen-thawed blastocysts transfer cycles

目的探讨人囊胚玻璃化冷冻-复苏后经体外培养后囊胚的复苏及体外培养时间对妊娠结局的影响。方法以冻融囊胚复苏后的162例为研究对象,根据解冻后不同培养时间分为2h移植组(A组,n=80)和次日(18h)移植组(B组,n=82);再根据囊胚的扩张情况(分1孵出、2完全扩张、3部分扩张、4无扩张),比较两组间的临床妊娠率和胚胎种植率的差异。结果 A组临床妊娠率和种植率分别为63.8%和43.5%,B组为49.38%和37.76%,组间差异无统计学意义(P>0.05);移植A1组临床妊娠率(90.0%)最高,但与A2组(63.6%)比较差异无统计学意义(P>0.05);A4组较低(33.3%),与A1、A2组比较有统计学差异(P<0.05)。B1组临床妊娠率(53.13%)与B2组(54.5%)比较差异无统计学意义(P>0.05);B3组最低(0%),与B1、B2组比较有统计学差异(P<0.05)。结论延长冻体外培养时间不能提高冻融囊胚移植周期的妊娠率和种植率,延长培养时间后,无扩张的囊胚发育潜能低.但可以通过观察复苏后囊胚的扩张情况评估其发育潜能,选择有发育潜能的囊胚进行移植。

Objective： To analyze the influence of culture time of b｜astocysts after thawing on biological and clinical pregnancy rates in frozen -thawed blastocysts transfer cycles. Methods： In 162 cycles of frozen -thawed blastocysts, We divided them into 2 groups according to the transplantation time after frozen - thawed blastocysts , they were group A （2 hours transferring after thawing , n = 80） and group B （ 18 hours transferring after thawing, n = 82）. And we also divided them into 4 sub - groups according to the situation of the expansion of the blastocyst （ sub - group 1 ： hatched , sub - group 2 ： completely expansion , sub - group 3 ： parts ex- pansion and sub - group 4 ： no expansion）. The implantation rates （ IRs）, pregnancy rates among groups were studied. Results ： The clinical pregnancy rate and implantation rate of group A were 63.8% and 43.5%, group B was 49. 38% and 37.76%, there was no statistically significant difference （P 〉 0. 05 ）. The clinical pregnancy of group A1 is the highest （90. 0% ）, but there was no statisti- cal significance with group A2 （63.6%） （P 〉 0.05） ; group A4 is low （33.3%）, there was statistically difference when comparing with group AI and A2 （P 〈 0.05）. The clinical pregnancy rate of Group BI was 53.13% and 54. 5% for group B2, there were no statistically significant difference （P 〉 0. 05 ） ; The clinical pregnancy rate of group B3 was the lowest （0%）, there was statistically different among group B1 and B2 （P 〈 O. 05）. Conclusion ： Prolonged the incubation time in vitro can＇t improve the implantation rate and pregnancy rate for transferring frozen - thawed blastoeysts cycle, the development potential of no expansion blastocyst was low. But we can evaluate the development potential by observing the expansion of the blastocyst through increasing the interval between thawing and transferring. We can select the better blastocysts to transfer after frozen - thawed.