卵裂球损伤对不同冻融方法胚胎移植后临床结局的影响

Analysis for influence of blastomere damage on clinical outcome in frozen-thawed embryo transfer

目的探讨卵裂球损伤对于不同冷冻方法冻融胚胎移植临床结局的影响。方法回顾性分析2009年1月至2013年12月共821例在本中心进行冻融胚胎移植的患者资料。根据胚胎卵裂球损伤情况分为A组：移植的胚胎均为卵裂球完整胚胎;B组：移植的2枚胚胎有1枚有卵裂球损伤;C组：移植3枚胚胎中只有1枚有卵裂球损伤;D组：移植3枚胚胎中只有1枚卵裂球完整胚胎;E组：移植胚胎均为卵裂球受损胚胎。按照冷冻方法（慢速程序法、玻璃化法）分别比较各组的临床资料和妊娠结局。结果慢速程序法中B、C、D三组临床妊娠率和胚胎种植率与A组相比均无显著性差异（P〉0.05）,而E组临床妊娠率和胚胎种植率显著低于A组（P〈0.05）。玻璃化法中A组临床妊娠率和胚胎种植率显著高于B、D、E三组（P〈0.05）。结论移植包含1~2枚卵裂球受损胚胎对于慢速程序化冻融胚胎移植临床结局无显著影响;对于玻璃化冻融胚胎移植,移植胚胎中卵裂球完整胚胎〈2枚时其临床妊娠率和胚胎种植率显著降低。

Objective： To explore the influence of blastomere damage on clinical outcomes in frozen-thawed embryo transfer based on the different cryopreserved method.Methods： A retrospective study was conducted on reproductive center from January 2009 to December 2013. frozen-thawed embryo transfer cycle in our A total of 821 patients was included in the study and divided into five groups according to the number of damaged blastomeres-Group A（all the transferred embryos were intact） ;Group B（one intact and one damaged embryo were transferred） ~Group C（two intact and one damaged embryo were transferred）;Group D （one intact and two damaged embryos were transferred） ~Group E（all transferred embryos were damaged）. The clinical characteristic and pregnancy outcome were compared with each other to investigate the influence of blastomere lysis on clinical outcome in frozen-thawed embryo transfer based on the different cryopreserved methods. Results： For slow-programmed freezing, no significant differences of clinical pregnancy and embryo implantation rate were found between Group A and Group B,C,D（P〉0. 05）. The clinical pregnancy and embryo implantation rates of Group A were significantly higher than those of Group E（P〈0.05）. For vitrification,clinical pregnancy and embryo implantation rates of Group A were significantly higher than those of Group B,D and E（P〈0.05）.