玻璃化冻融胚胎提前解冻与当日解冻移植结局比较

Comparison of vitrified-thawed embryo transfer outcomes at different transfer times

目的比较玻璃化冻融胚胎提前解冻培养后移植与当日解冻胚胎移植（FET）之间的移植结局。方法回顾性分析了2013年3月～10月在我中心进行的462例FET周期,提前解冻培养后移植组（A组224例）,当日解冻移植组（B组238例）;又将A组按卵裂球增殖与否分为Ⅰ组（108例）均增殖,Ⅱ组（84例）部分增殖,Ⅲ组（32例）均无增殖;根据冷冻胚胎卵裂球数目再将A、B两组又分为A1组（159例）、B1组（164例）胚胎卵裂球数均〉6,A2组（65例）、B2组（74例）至少有一枚胚胎卵裂球数≤6,比较各组间的移植结局。结果A组与B组临床妊娠率和着床率分别为44.2%,44.1%;28.1%,26.5%,均无统计学差异（P〉0.05）;Ⅰ组的着床率与Ⅲ组相比较（33.1%vs.17.7%）,差异有统计学意义（P〈0.05）;A1、B1组临床妊娠率和着床率均明显高于B2组,差异均有统计学意义（P〈0.01）;A2组着床率较B2组高,差异有统计学意义（P〈0.05）。结论冷冻胚胎提前解冻培养后再移植并不能改善FET结局,但对于卵裂球数目较少的冷冻胚胎,提前解冻培养或许有助于改善其着床率和临床妊娠率。

Objective. To compare the outcomes of vitrified-thawed embryo transfer at different transfer times. Methods. A retrospective study was carried out in 462 frozen-thawed embryo transfer（FET）cycles in our center from March 2013 to October. The embryos were transferred either on the same day after thawing（group B）or the one day（group A）befor thawing. According to whether or not embryos developed during the post-thawed culture, group A was subdivided into the following 3 groups, group I with all embryos developed（n=108）;groupⅡ with some of embryos developed（n=84） ;group Ⅲ with none of the embryo developed（n= 32）. According to the number of blastomeres of the frozen embryos,group A and group B were subdivided into four groups： group A1 （n= 159） and Bl（n= 164）that all of the number of blastomeres〉6,and group A2（n=65）and B2（n=74）,which had at least one embryo with the number of blastomeres≤6. Results. There was no significantly difference in the pregnancy rate （44.2 % vs. 44.1%）and embryo implantation rate（28.1% ,26.5 %）between group A and group B（P〉0.05）. The embryo implantation rate of group I（33.1% vs. 17.7%）was higher than that of group Ⅲ （P〈0.05）. The pregnancy rate and embryo implantation rate of group B2 were significantly lower than group A1 and group B1（P〈0.01）. And the embryo implantation rate of group A2 was significantly lower than that of group B1 ,but which was higher than that of group B2（P〈0.05）.Conclusions： That the frozen embryos were thawed one day in advance and cultured dose not significantly increase the pregnancy rate and embryo implantation rate, but may improve the outcomes of FET for the frozen embryos with fewer blastomeres.