卵裂期胚胎解冻后囊胚培养临床结局的相关因素的研究

Clinical outcomes of embryos thawed in cleavage stage transfer after culcure to blastocyst

目的探讨研究解冻后卵裂期胚胎行囊胚培养后临床结局的相关因素分析。方法收集我院生殖医学中心2015年3月-2017年5月解冻并进行囊胚培养的分裂期胚胎,如继续发育后行胚胎移植,并随访其临床结局。结果临床妊娠和出生率与是否移植完整胚胎、是否移植优质囊胚无明显相关(P>0.05)。至少移植一枚以上囊胚组的临床妊娠率为58.4%,出生率为49.6%;8例移植胚均未发育至囊胚组无临床妊娠(P<0.01,fisher′s exact test)。未形成囊胚组冷冻时和移植时年龄均显著高于囊胚形成组(P<0.01);囊胚形成组的平均完整存活数明显高于未形成囊胚组(P<0.05)。结论冷冻胚胎解冻后,囊胚的形成与解冻后胚胎完整度以及年龄相关。解冻后培养至5-6天的胚胎如无囊腔形成,则可能其种植潜能差,仍需加大样本量进一步研究。

Objective：To investigate the related factors of clinical outcomes of frozen-thawed embryos which cultured to blastocyst. Methods：The embryos of Day 3 thawed and cultured to blastocysts from March 2015 to May 2017 in our hospital were collected. Clinical outcomes were followed up after embryo tranfer which continued to develop. Results：There was no significant correlation between clinical outcome and whether the whole embryo was transfered or whether high quality blastocyst was transfered（P〈0.05）. The clinical pregnancy rate was 58.4% in at least one blastocyst transfered group and the birth rate was 49.6%. All of the 8 cases without blastocyst trasfered had no clinical pregnancy（P〈0.01,Fisher′s exact test）. The age at time of freezing or transfer in group without blastocyst formation was significantly higher than that in group with at least one blastocyst formation（P〈0.01）. The intct embryo number in group with at least one blastocyst formation was significantly higher than that of without blastocyst formation group（P〈0.05）. Conclusion：In frozen-thawed embryos,blastocyst formation rate were related to embryo integrity and age. After thawing,embryos cultivated to 5-6 days without cystic cavity may have poor potential for planting,and further studies are still needed to increase the sample size.