激光辅助孵化技术在透明带异常患者新鲜移植周期中的应用及安全性分析

Application and safety of laser-assisted hatching in fresh transplantation cycle in patients with abnormal zona pellucida

目的探讨透明带异常患者新鲜移植周期中应用激光辅助孵化(AH)技术的临床结局及其安全性。方法回顾性分析2013年1月至2016年12月在本中心进行IVF-ET的透明带异常患者的临床资料,总例数为154例。按照纳入标准对第3天移植的115例透明带异常患者进行筛选,符合纳入标准的48例患者均行激光AH,设为AH组;随机筛选透明带正常未行激光AH的患者290例设为对照组;比较两组患者的一般资料及临床妊娠结局。结果 AH组和对照组两组患者的一般资料,如年龄、体重指数(BMI)、激素水平及内膜厚度比较差异均无统计学意义(P>0.05)。AH组患者48例,临床妊娠34例,临床妊娠率70.83%;对照组患者290例,临床妊娠219例,临床妊娠率75.52%,两组临床妊娠率比较无统计学差异(P>0.05)。两组的多胎率、活产率、早产率、流产率及异位妊娠率比较差异亦无统计学意(P>0.05)。结论对于透明带异常但具有优质胚胎的患者,行激光AH可以改善患者的妊娠结局,且并未增加流产率、畸形率、多胎率等不良结局风险。

Objective：To investigate the clinical outcomes and safety of laser assisted hatching（AH）in the patients with abnormal zona pellucida.Methods： A retrospective analysis of 154 patients with abnormal zona pellucida in our center from January 2013 to December 2016 was conducted.One hundred and fifteen patients whose embryos were transplanted on Day 3 were screened again according to the inclusion criteria.The embryos of 48 patients who met the inclusion criteria were treated by laser AH and set as AH group.Another 290 patients with normal zona pellucida and without laser assisted hatching were randomly selected and set as the control group.The general data and clinical pregnancy outcomes were compared between the two groups.Results：There was no significant difference in the general data of patients,such as age,body mass index（BMI）,hormone levels,and endometrial thickness between the AH group and the control group（P〈0.05）.Of the 48 patients,34 had clinical pregnancy,and the clinical pregnancy rate was 70.83%in the AH group.Of the 290 patients,219 had clinical pregnancy,and the clinical pregnancy rate was 75.52%in the control group.There was no significant difference in clinical pregnancy rate between the two groups（P〉0.05）.There were also no significant differences in the multiple pregnancy rate,live birth rate,premature delivery rate,abortion rate and ectopic pregnancy rate between the two groups（P〉0.05）.Conclusions：The patients with abnormal zona pellucida,but with high quality embryos,are eligible for laser assisted hatching before transplantation,which can improve the pregnancy outcomes and does not increase the adverse outcomes such as abortion rate,deformity rate and multiple birth rate.