不同级别胚胎玻璃化冷冻时长对复苏周期临床结局的影响

Effects of different grades of embryo vitrification duration on clinical outcomes of resuscitation cycle

目的探讨不同级别胚胎玻璃化冷冻时长对复苏周期妊娠结局的影响。方法回顾性分析2016年1月至2021年12月在中国人民解放军联勤保障部队第九〇四医院生殖中心行玻璃化冷冻胚胎复苏移植的2210个周期,按胚胎级别分为4类:卵裂期1级、2级、3级胚胎及囊胚期胚胎;按时间分为6组:第1组≤180d(1122个周期),第2组180~<360d组(507个周期),第3组360~<720d组(216个周期),第4组720~<1080d(195个周期),第5组≥1080d(170个周期),比较各组患者的基本情况、临床结局。结果解冻卵裂期1级胚胎妊娠率、种植率随冷冻时间延长降低,其中第1组最高,分别为68.3%和70.7%(P<0.05);解冻卵裂期2级胚胎随冷冻时间延长妊娠率、种植率比较,差异有统计学意义(P<0.05),其中1、4、5组比较,差异有统计学意义(P<0.05);解冻囊胚期胚胎妊娠率、种植率随冷冻时间延长降低,第1组最高,分别为66.7%和62.3%(P<0.05);各组卵裂期及囊胚期胚胎活产率、流产率比较,差异无统计学意义(P>0.05)。结论随着冷冻时间的延长,卵裂期优质胚胎及囊胚妊娠率、种植率有下降趋势;胚胎的短期冷冻(≤180d)可提高临床妊娠率;胚胎冷冻时间延长虽不影响活产率、流产率,但仍鼓励取卵后半年内择优移植。

Objective To investigate the effect of different grades of embryo vitrification duration on pregnancy outcome of frozen-thawed cycles.Methods The data of 2210 cycles of vitrified-thawed embryo transfer in 904th Hospital of Joint Logistic Support Force of PLA from January 2016 to December 2021 were retrospectively analyzed.According to the embryo level,it was divided into four categories:cleavage stage primary,secondary,tertiary embryos and blastocyst stage embryos.The cycles were divided into six groups according to embryo cryopreservation time:Group 1≤180d(1122cycles),Group 2>180~<360d(507cycles),Group 3>360~<720d(216cycles),Group 4>720~<1080d(195cycles),Group 5≥1080d(170cycles),the differences of patients general data,clinical outcomes were compared.Results The pregnancy rate and implantation rate of thawed cleavage stage first-level embryos decreased with the extension of freezing time,and the highest in group 1 was 68.3%and 70.7%,respectively(P<0.05).The pregnancy rate and implantation rate of thawed cleavage stage secondary embryos were significantly different with the extension of freezing time(P<0.05),and there were differences in groups 1,4,and 5.The pregnancy rate and implantation rate of thawed blastocyst stage embryos decreased with the extension of freezing time,and the highest in group 1 were 66.7%and 62.3%,respectively(P<0.05).There was no significant difference in the live birth rate and abortion rate of embryos at the cleavage stage and blastocyst stage among the groups(P>0.05).Conclusion With the extension of freezing time,the pregnancy rate and implantation rate of first-and second-level embryos at cleavage stage and blastocyst stage embryos have a downward trend.Short-term freezing of embryos(≤180days)can improve clinical pregnancy rates.Although the extension of embryo freezing time does not affect the live birth rate and abortion rate,it is still encouraged to select the best transfer within six months after Oocyte retrieval.