激光辅助孵化在玻璃化冻融胚胎移植周期中的应用

Application of laser-assisted hatching in vitrified-warmed cycles

目的探讨激光辅助孵化(laser-assisted hatching,LAH)在玻璃化冻融周期中的应用效果。方法回顾性分析639个玻璃化冻融移植周期,根据解冻胚胎天数以及是否行LAH,分为4组:A组(解冻D3胚胎,行LAH)、B组(解冻D3胚胎,不行LAH)、C组(解冻D6囊胚,行LAH)、D组(解冻D6囊胚,不行LAH);比较患者一般情况和妊娠结局。结果C组和D组的临床妊娠率(65.43%、60.27%)、胚胎种植率(50.98%、39.44%)显著高于A组(分别为34.25%、21.36%)和B组(分别为34.21%、19.28%)(P<0.05);A组与B组的临床妊娠率、胚胎种植率和多胎率比较均无统计学差异(P>0.05);C组的胚胎种植率和多胎率(分别为50.98%、47.17%)显著高于D组(分别为39.44%、27.27%)(P<0.05)。四组患者的流产率、异位妊娠率均无统计学差异(P>0.05)。结论LAH可提高玻璃化冻融囊胚移植周期的胚胎种植率。

Objective： To investigate the effects of laser-assisted hatching（LAH）in vitrified-warmed cycles. Methods： The data of 639 vitrified-warmed embryo transfer （FET）cycles were retrospectively analyzed. According to the embryo age and whether the LAH was performed,the cycles were divided into 4 groups：Group A：Day 3 embryo FET with LAH;Group B： Day 3 embryo FET without LAH;Group C： Day 6 blastocyst FET with LAH;Group D： Day 6 blastocyst FET without LAH;The general condition and pregnancy outcome were compared among the groups. Results： The clinical pregnancy rate and implantation rate of Group C （65.43% and 50.9 respectively）and Group D（60.27% and 39.44%）were significantly higher than that of Group A（34.2 % and 21.36 %）and Group B（34.21% and 19.28%）（P〈0.05）. There were no significant differences in the rates of clinical pregnancy and implantation between Group A and Group B（P〉0.05）. The implantation rate（50.98% vs. 39.44%）and multi-pregnancy rate（47.17% vs. 27 higher than those of Group D（P〈0.05）. There were no significant and ectopic pregnancy among the four groups（P〉0.05）. 27 %）of Group C were significantly differences in the rate of miscarriage Conclusions： Laser-assisted hatching （LAH）can increase the implantation rate in vitrified-warmed cycles.