激光皱缩对不同发育时间和级别的单囊胚冷冻复苏周期临床结局的影响

Effect of Laser Artificial Shrinkage on Pregnancy Outcome of Single Blastocysts Transfer with Different Developmental Days and Stages in the Frozen-thawed Cycles

目的探讨激光皱缩对不同发育时间和级别的单囊胚玻璃化冷冻复苏周期临床结局的影响。方法回顾性分析广西玉林市妇幼保健院生殖中心行冻融单囊胚移植336例患者的临床资料。根据是否进行激光皱缩将其分为激光皱缩组(227例),未皱缩组(106例)。按照囊胚发育时间进一步将其分为皱缩D5组、皱缩D6组、未皱缩D5组和未皱缩D6组;按照囊胚内细胞团和滋养层评分分为皱缩优胚组、皱缩非优胚组、未皱缩优胚组和未皱缩非优胚组,分别比较不同发育时间和级别单囊胚激光皱缩后冻融移植的临床结局。结果相同发育时间的单囊胚比较,激光皱缩D5组流产率高于未皱缩D5组,差异有统计学意义(P <0.05);皱缩组与未皱缩组其他结局指标差异无统计学意义(P> 0.05)。相同级别的单囊胚比较,皱缩优胚组妊娠率高于其他各组差异有统计学意义(P <0.05)。结论激光皱缩可提高优质单囊胚移植的临床妊娠率,但有增加D5单囊胚流产率的风险。

Objective To investigate the effect of laser artificial shrinkage on the pregnancy outcome of single blastocysts transfer with different developmental days and stages in in the frozen-thawed cycles Methods The clinical data of 336 cases of frozen thawed single blastocyst transplantation cycles in reproductive center of Yulin maternal and Children Health Hospital in Guangxi were analyzed retrospectively.According to whether laser shrinkage was performed,the patients were divided into laser shrinkage group(227 cases)and non-shrinkage group(106 cases).According to the development time of blastocyst,the experimental group was divided into five groups:shrinkage D5 group,shrinkage D6 group,non shrinkage D5 group and non shrinkage D6 group.Then according to the score of cell mass and trophoblast layer in blastocyst,the experimental group was divided into three groups:shrinkage D5 group,shrinkage D6 group,non shrinkage D5 group and non shrinkage D6 group.The clinical outcomes of cryothaw transfer of single blastocysts with different developmental time and different grades were compared among the three groups.Results Compared with the single blastocyst and with the same development time,the abortion rate of D5 group with laser shrinkage was higher than that of D5 group without shrinkage,and the difference was statistically significant(P<0.05).There were no statistically significant differences in the other outcome indicators between the wrinkled group and the non-wrinkled group(P>0.05).Compared with the single blastocysts of the same grade,the pregnancy rate of the wrink-led embryo group was significantly higher than that of the other groups(P>0.05).Conclusion Laser shrinkage can improve the clinical pregnancy rate of high quality single blastocyst transplantation but it can also increase the risk of D5 single blastocyst abortion rate.