慢冻与玻璃化冷冻解冻胚胎囊胚培养后临床结局的比较研究

Analysis of embryos after blastocyst culcure and clinical outcomes following vitrification versus slow freezing

目的比较研究在玻璃化冷冻和慢冻解冻后卵裂期胚胎的发育潜能和临床结局。方法在我院生殖医学中心以同期慢速冷冻解冻胚胎为对照,收集2015年3月-2017年5月在行玻璃化冷冻解冻的分裂期胚胎,并进行囊胚培养,如继续发育后行胚胎移植,并随访比较其临床结局。结果玻璃化组复苏率为99.4±4.1%,囊胚形成率为60.0%±33.0%,临床妊娠率为56.8%(54/95),出生率为47.4%(45/95);慢冻组复苏率为95.2±12.2%,囊胚形成率为48.3%±29.6%,临床妊娠率为50.0%(19/38),出生率为44.7%(17/38)。两组冻胚时年龄、冷冻时平均优质胚胎数比较,差异无统计学意义(P>0.05);两组囊胚形成率、临床妊娠率和出生率比较,未发现差异有统计学意义(P>0.05)。结论胚胎的玻璃化冷冻保存,可以获得比较满意的囊胚形成率和临床结局;囊胚培养可以进一步筛选具有种植潜能的胚胎。

Objective：To compare the developmental potential and clinical outcome of cleavage stage embryos following vitrification and slow freezing. Methods：Collect frozen-thawed embryos from March 2015 to May 2017 and carried out blastocyst culture following vitrification and slow freezing,and analysis clinical outcomes of embryo transfer cases. Results：The survival rate of vitrified group was 99.4±4.1%,the blastocyst formation rate was 60.0% ± 33.0%,the clinical pregnancy rate was 56.8%（54/95）and the birth rate was 47.4%（45/95）. The survival rate of slow freezing group was 95.2±12.2%,the rate of blastocyst formation was 48.3%±29.6%,the clinical pregnancy rate was 50.0%（19/38）and the birth rate was 44.7%（17/38）.There were no significant differences in the age at embryos frozen and the average number of high quality embryos frozen（P〉0.05）.There was no significant difference in blastocyst formation rate,clinical pregnancy rate and birth rate between the two groups（P〉0.05）. Conclusion：Vitrification of embryos can be used to obtain more satisfactory blastocyst formation rate and clinical outcome. Blastocyst culture can further screen embryos with potential for implantation.