卵子玻璃化冷冻在辅助生殖技术治疗中的临床应用

Clinical application of egg vitrification on assisted reproductive technology therapy

目的探讨卵子冷冻以及冻卵冻胚(卵裂胚及囊胚)双次冷冻在辅助生殖技术(ART)中临床应用的安全性和可行性。方法回顾性分析2014年1月—2017年12月期间行卵子玻璃化冷冻,随后解冻并后续培养移植共164个周期,其中新鲜胚胎移植组解冻卵88个周期,冻融胚胎移植卵裂胚组冻卵冻胚40个周期,冻融胚胎移植囊胚组冻卵冻囊胚36个周期,并分别以同期未行卵子冷冻的新鲜胚胎(n=1 480)、解冻胚胎(n=246)、解冻囊胚(n=304)移植作为对照,比较卵子受精率、卵裂率及可利用胚胎率,以及各组的复苏率、后续的着床率、临床妊娠率、早期流产率、活产率等指标。结果解冻卵复苏存活率为[94.00%(999/1 063)]。解冻卵受精率[84.00%(838/999)]优于新鲜卵子受精率[72.67%(10 703/14 729)],组间差异有统计学意义(P=0.00),第3日可利用胚胎率、冻融后存活率、着床率、临床妊娠率、早期流产率、活产率差异均无统计学意义(P>0.05)。结论卵子冷冻不会降低卵子的发育潜能,冷冻后可获得比较满意的复苏效果,行卵胞质内单精子显微注射(ICSI)仍可获得较好的妊娠和活产结局,对于需要保存生育力的女性来说卵子冷冻是一种较为安全有效的方法。

ObjectiveTo investigate the safety and feasibility of egg vitrification and refrozen embryo in assisted reproductive technology （ART）. MethodsPatients with intracytoplasmic sperm injection （ICSI） treatment in our hospital from January 2014 to December 2017 were retrospectively analyzed. The thawing egg cycles （n=164, including 88 cycles with frozen eggs, 40 cycles with refrozen embryos, 36 cycles with refrozen blastocyst） were compared with fresh egg cycles in the same period, to get the index of survival rate, fertilization rate, available embryo rate, and subsequent implantation and pregnancy outcomes. ResultsSurvival rate of thawing eggs was 94.00%. The fertilization rate of thawing eggs （84.00%） was significantly higher than that of fresh eggs （72.67%） （P=0.00）. And there were no statistical differences in available embryo rate of day 3, embryo survival rate, implantation rate, clinical pregnancy rate, early abortion rate and live birth rate （P〉0.05）. ConclusionEgg vitrification does not reduce the development potential of the embryo. Frozen eggs can achieve a satisfactory recovery results, with good pregnancy outcomes. In conclusion, for women who need to preserve fertility, egg vitrification is a relatively safe and effective method.