桌面干式培养箱在体外受精胚胎培养中的临床效果观察

Evaluation of desktop dry incubator use for embryo culture in in vitro fertilization

目的评估桌面干式培养箱与传统湿式培养箱在胚胎培养中的效果差异。方法回顾性分析2019年1月至2022年9月于我院生殖中心就诊行体外受精(IVF)治疗的共3177个周期的临床资料。根据培养环境不同分为两组:以传统湿式箱培养的为C200(湿式)组(n=2820),以桌面干式培养箱培养的为MIRI(干式)组(n=357),比较两组的患者一般情况、胚胎培养情况和妊娠结局。结果两组间女方年龄、体质量指数(BMI)、不孕年限、不孕类型、基础卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、窦卵泡数计数(AFC)、促性腺激素(Gn)总量比较均无显著差异(P>0.05);两组间双原核(2PN)率、D3优胚率、D3可用胚胎率、囊胚形成率比较均无显著差异(P>0.05)。在D3卵裂期胚胎新鲜移植的患者中,C200(湿式)组活产率显著低于MIRI(干式)组(36.06%vs.46.09%,P<0.05),两组间胚胎种植率、临床妊娠率、流产率、早产率、双胎率及胎儿出生体重比较均无显著差异(P>0.05)。在D5囊胚新鲜移植患者中,C200(湿式)组流产率显著低于MIRI(干式)组(13.20%vs.20.63%,P<0.05),两组间胚胎种植率、临床妊娠率、活产率、早产率、双胎率及胎儿出生体重比较均无显著差异(P>0.05)。结论两种培养模式整体上可获得相似的胚胎培养结果,但桌面干式培养箱可能更适合于D1~D3胚胎的培养,而D4至囊胚阶段的培养更适合在传统湿式培养箱中进行。

Objective:To evaluate the difference between desktop dry incubators and traditional humid incubators in embryo culture.Methods:Data of patients undergoing in vitro fertilization(IVF)procedure at the Reproductive Center of Northwest Women’s and Children’s Hospital from January 2019 to September 2022 were retrospectively analyzed,and a total of 3177 cycles were included.Among them,2820 cycles were cultured in traditional humid incubators as the C200 group while 357 were in desktop dry incubators as the MIRI group.The general characteristics,embryo culture and pregnancy outcomes of the two groups were compared.Results:There were no significant differences in the female age,body mass index(BMI),infertility years,infertility types,and basal levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),antral follicle count(AFC)and total gonadotropin(Gn)between the two groups(P>0.05).There were also no significant differences in 2PN rate,top D3 quality embryo rate,available D3 embryo rate and the blastocyst formation rate between the two groups(P>0.05).Among the patients with fresh D3 embryo transfer,the live birth rate of C200(wet)group was significantly lower than that of MIRI(dry)group(36.06%vs.46.09%,P<0.05),and no significant differences were detected in embryo implantation rate,clinical pregnancy rate,the abortion rate,preterm birth rate,the rate of twin pregnancy and fetal birth-weight between the two groups(P>0.05).Among patients with fresh D5 blastocyst transfer,the abortion rate of C200(wet)group was significantly lower than that of MIRI(dry)group(13.20%vs.20.63%,P<0.05),and there were no significant differences in embryo implantation rate,clinical pregnancy rate,live birth rate,preterm birth rate,the rate of twin pregnancy and fetal birth weight between the two groups(P>0.05).Conclusions:Desktop dry incubators may be more suitable for D1 to D3 embryo culture,while traditional wet incubators are more suitable for D4 to blastocyst stage culture.