玻璃化冷冻对冻融卵裂期胚胎移植周期结局的影响

Influence of vitrification method on clinical outcome of human frozen-thawed cleaved embryo transfer

目的探讨玻璃化冷冻法对卵裂期冻融胚胎移植周期结局的影响。方法将接受体外受精-胚胎移植患者剩余的可利用胚胎进行玻璃化冷冻或者慢速程序化冷冻，比较胚胎复苏后的复苏率、胚胎存活率、完整存活率、种植率、妊娠率等指标。结果玻璃化冷冻复苏248个周期、746个胚胎，存活643个（86．2％），完整存活594个（79．4％），移植244个周期，临床妊娠107个周期（43．9％），种植率26．1％，流产9个周期（8．5％）。慢速程序冷冻复苏225个周期、818个胚胎，存活598个（73．1％），完整存活436个（53．3％），移植225个周期，临床妊娠74个周期（32．9％），种植率15．2％，流产7个周期f9．5％）。玻璃化法冷冻后的胚胎存活率、完整存活率、临床妊娠率、种植率明显高于慢速程序冷冻法（P〈0．05）。结论玻璃化冷冻法是冻存人类卵裂期胚胎理想的方法，可以提高胚胎的有效利用。

Objective To investigate the influence of vitrification method on clinical outcome of human frozen-thawed cleaved embryo transfer. Methods In the in vitro fertilization and embryo transfer cycles, supernumerary embryos were cryopreserved by vitrification or slow-freezing sequencing method. The embryo survival rate, intact survival rate, pregnant rate and implantation rate were compared after thawing. Results In 248 vitrified embryo thaw cycles, 746 vitrified embryos were thawed, and 643（86.2%） of them survived and 594（79.4%） of them intactly survived after the thawing. In 244 women, 632 embryos were transferred, and 107（43.9%） of them got clinical pregnancy, the implantation rate was 26.1% （165/632）. As to slow- freezing method, in 225 embryo thaw cycles, 818 embryos were thawed, 598 （73.1%） of them survived, 436（53.3%） of them intactly survived, and 594 embryos were transferred in 225 cycles, and 74 （32.9%） of them got clinical pregnancy, the implantation rate was 15.2%（90/594）. The embryo survival rate, intact survival rate, pregnant rate, implantation rate were higher in vitrification group than those in slow-freezing group （P 〈 0.05）. Conclusion Vitrification is a more effective method of cryopreserving the human embryo than conventional slow freezing.