激光人工皱缩在玻璃化冷冻法保存人类囊胚中的效果分析

Effect analysis of laser-drilling artificial shrinkage used to human blastocyst vitrification cryopreservation

目的:评估囊胚玻璃化冷冻前用激光对囊胚腔进行皱缩的临床效果。方法:激光打孔使囊胚腔皱缩后将囊胚玻璃化冷冻(皱缩组)或直接将囊胚玻璃化冷冻(对照组),比较两组的临床效果。结果:317个囊胚解冻周期均进行了移植。其中对照组178例和皱缩组139例,两组年龄、不孕年限、内膜厚度、平均移植胚胎数、优质囊胚率、流产率、多胎妊娠率和异位妊娠率比较未见差异(P>0.05);对照组的临床妊娠率(44.9%)、种植率(34.4%)均低于皱缩组(66.9%、48.5%)(P=0.001)。结论:囊胚玻璃化冷冻前使用激光打孔人工皱缩可显著提高临床妊娠和着床率,值得临床探索应用。

Objective：To investigate clinical effect of laser drilling-artificial shrinkage（LDAS）of blastocoels before blastocysts vitrification cryopreservation.Methods：The human blastocysts free-thawed blastocyst cycles（FTB）were performed with laser-drilling shrinkage before vitrified cryopreservation（shrinkage group）or without laser-drilling shrinkage before vitrified cryopreservation（control group）.The outcomes were compared between the two groups.Results：All the frozen-thawed blastocysts in two groups had been embryos transferred in clinic,which included total 317 FTB cycles.178 FTB cycles have been taken in control group,and other 139 FTB cycles had been taken in shrinkage group.the age of patients,the years of infertility,endometrium thickness on ovulation day,average number of the embryos transferred,high quality blastocyst rate,abortion rate,multiple pregnancy rate and ectopic pregnancy rate had no statistical difference in the two groups（P〉0.05）.The clinical pregnancy rate（44.9%）and the implantation rate（34.4%）in control group were significant lower than those in shrinkage group（66.9%and 48.5%,respectively）（P=0.001）.Conclusion：The clinical pregnancy rate and implantation rate of FTB are significantly improved by LDAS of blastocoels before vitrified cryopreservation,which is worthy of clinical exploration and application.