冻融周期不同囊胚移植策略的临床结局比较

Comparison of clinical outcomes of blastocysts implantation in the vitrified frozen-thawed cycles

目的比较冻融囊胚后移植和冻融D3卵裂期胚胎培养至囊胚后移植的临床结局。方法回顾性分析我院生殖中心2015年7月至2019年7月冻融周期完成的囊胚移植791个周期,其中冻融可利用囊胚移植372个周期(A组),冻融D3卵裂期胚胎培养至可利用囊胚移植261个周期(B组),冻融D3卵裂期胚胎培养至低质量囊胚移植158个周期(C组)。结果A组和B组相比,临床妊娠率、种植率、流产率及宫外孕率差异均无统计学意义(P>0.05);C组同B组相比,临床妊娠率、种植率和多胎率均会降低,差异有统计学意义(P<0.05)。结论冻融囊胚移植或是冻融卵裂期胚胎培养至囊胚移植两种策略的选择,并不改变移植后的妊娠结局。在冻融周期无可利用囊胚形成的情况下,可结合患者实际情况决定是否移植低质量囊胚。

Objective The purpose of this study was to compare the clinical outcomes of vitrified frozenthawed blastocyst transfer and transplantation of blastocyst cultured from vitrified frozen-thawed D3 cleavage embryo.Methods A total of 791 blastocysts implantation cycles from July 2015 to July 2019 were analyzed,which included 372 cycles of frozen-thawed blastocysts transplantation(group A),261 cycles of blastocysts implantation by sequential culture after frozen-thawed D3 cleavage embryos(group B)and 158 cycles of low-quality blastocysts implantation by sequential culture after frozen-thawed D3 cleavage embryos(group C).Results There was no significant difference in clinical pregnancy rates,implantation rates,abortion rates and ectopic pregnancy rates between the group A and group B.Compared with group B,the clinical pregnancy rate,implantation rate and and multiple birth rate in group C were significantly low(P<0.05).Conclusions The two strategies of freeze-thaw blastocyst transplantation or freeze-thaw cleavage embryo culture to blastocyst transplantation did not change the pregnancy outcome after transplantation.Transplantation of low-quality blastocyst may be a candidate when there is no blastocyst formation available in the freeze-thaw cycles.