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1.
目的:比较辅助生殖技术中玻璃化和程序化2种冷冻方法对卵裂期胚胎的冷冻复苏效果。方法:对265个玻璃化冷冻周期和276个程序化冷冻周期的相关资料进行回顾性统计学分析,比较冷冻胚胎复苏后的胚胎存活率、胚胎种植率和临床妊娠率等指标。结果:玻璃化冷冻复苏265个周期,解冻809个胚胎,存活710个(87.8%),移植259个周期,临床妊娠98个周期(37.8%),其中双胎妊娠26例,三胎妊娠3例。程序冷冻复苏276个周期,解冻968个胚胎,存活532个(55.0%),移植246个周期,临床妊娠70例(28.5%),其中双胎妊娠4例,三胎妊娠1例。玻璃化冷冻后的胚胎存活率和完整性胚胎存活率均显著高于程序化冷冻,复苏周期移植取消率显著低于程序化冷冻,而临床妊娠率则明显高于程序化冷冻,差异均有统计学意义(P<0.05)。但2种方法的胚胎种植率无统计学差异(P>0.05)。结论:玻璃化法能够较好地避免冷冻引起的损伤,适用于卵裂期胚胎的冷冻保存。  相似文献   

2.
目的:探讨用玻璃化冷冻法冷冻桑葚期胚胎的可行性.方法:选择2010年6月至2012年9月在河北医科大学第二医院生殖医学门诊行体外受精-胚胎移植患者784例(829个周期)为研究对象,对照组(606例)为前期采用玻璃化冷冻法冷冻第3天卵裂期胚胎637个周期;研究组A(145例)采用玻璃化冷冻法冷冻第4天桑葚期胚胎159个周期;研究组B(33例)为前期采用玻璃化冷冻法冷冻胚胎在第3天评分较差,介于冷冻和非冷冻之间的胚胎,通过继续培养至第4天采用玻璃化冷冻法冷冻桑葚期胚胎33个周期.3组均解冻以后行冻融胚胎移植,比较3组复活周期的胚胎完整率、周期临床妊娠率、种植率以及流产率.结果:①研究组A的完整胚胎存活率、周期临床妊娠率和流产率高于对照组,但差异无统计学意义(P>0.05).而研究组A的胚胎种植率(33.2%)高于对照组(27.0%),差异有统计学意义(P<0.05);②研究组B和对照组比较,完整胚胎存活率、种植率、周期临床妊娠率和流产率方面,差异均无统计学意义(P>0.05).结论:桑葚期胚胎较原核期胚胎和早期卵裂期胚胎处于胚胎发育的更晚阶段,是胚胎的进一步选择,其玻璃化冷冻是可行的,能获得较好的妊娠率和种植率,值得临床推广应用.  相似文献   

3.
目的:比较开放式与封闭式自制叶片玻璃化冷冻技术对人早期胚胎冷冻复苏的效果。方法:以自制开放式与封闭式的叶片为冷冻载体,用玻璃化冷冻方法冷冻体外受精-胚胎移植第3天移植后剩余的优质胚胎,观察胚胎复苏及临床妊娠情况。结果:开放式冻存组共复苏112个周期、288个胚胎,胚胎复苏率、复苏5h继续卵裂率、空泡出现率、胚胎丢失率、临床妊娠率、植入率及流产率分别为97.2%、30.7%、9.3%、1.7%、50.5%、23.6%、14.5%,相较于封闭式冻存组(共复苏93个周期、222个胚胎)的胚胎复苏率(96.4%)、复苏5h继续卵裂率(34.6%)、空泡出现率(7.9%)、胚胎丢失率(1.4%)、临床妊娠率(59.8%)、植入率(29.0%)、流产率(10.9%)均无统计学差异(P>0.05)。结论:封闭式玻璃化冷冻法能获得与开放式同样的冷冻效率,且能使胚胎与液氮完全隔离,能更好地保护胚胎避免潜在的病原微生物、病毒的污染,是冷冻人早期胚胎理想的方法。  相似文献   

4.
目的:探讨在体外受精-胚胎移植(in-vitro fertilization-embryo transfer,IVF-ET)过程中,卵裂期胚胎冷冻10年后解冻复苏再移植成功妊娠的可能性。方法:1例患者卵裂期胚胎冷冻10年后解冻复苏并行囊胚培养,获得囊胚后再次冷冻1年后复苏,行囊胚移植。结果:该患者移植后顺利获得临床妊娠,并于孕38周剖宫产一健康男婴。结论:长期保存的胚胎解冻后重新冷冻对最终获得妊娠依然有价值;冷冻胚胎囊胚培养有助于提高卵裂期胚胎冷冻复苏后的利用价值及提高胚胎着床率。  相似文献   

5.
Li Y  Chen ZJ  Yang HJ  Zhong WX  Ma SY  Li M 《中华妇产科杂志》2007,42(11):753-755
目的比较慢速程序化冷冻法(慢速法)和玻璃化冷冻法(玻璃化法)对第3天分裂期胚胎发育潜能的影响。方法选择因输卵管阻塞或男性少弱精因素行体外受精(IVF)或卵母细胞胞质内单精子注射(ICSI)治疗的患者,挑选在行IVF或ICSI后第3天剩余优质胚胎数目超过4个者80例进入本研究。随机将每例患者的2个胚胎用玻璃化法冷冻,另外2个用慢速法冷冻;冷冻复苏后随机抽取40例患者移植慢速法冷冻的胚胎,另40例患者移植玻璃化法冷冻的胚胎,比较2种冷冻方法对胚胎发育潜能的影响。结果冷冻复苏后待移植的胚胎共160个,其中慢速法冷冻80个,复苏后存活73个(91%,73/80),移植后40例患者中15例(38%,15/40)获得临床妊娠,其中3例(20%,3/15)为双胎妊娠,余为单胎妊娠,胚胎着床率为25%(18/73);玻璃化法冷冻胚胎80个,复苏后存活71个(89%,71/80)。移植后40例患者中19例(48%,19/40)获得临床妊娠,其中9例(47%,9/19)为双胎妊娠,余为单胎妊娠,胚胎着床率为39%(28/71),与慢速法相比,玻璃化法的临床妊娠率和双胎妊娠率均有提高,但差异无统计学意义(P〉0.05),而胚胎着床率则显著提高,差异有统计学意义(P〈0.05)。结论玻璃化法能够更好地保存胚胎复苏后的发育潜能,更适合第3天分裂期胚胎的冷冻保存。  相似文献   

6.
目的:比较玻璃化冷冻与程序化冷冻对胚胎发育潜能及临床结局的影响。方法:回顾性分析590个复苏周期,比较2种冷冻方法的胚胎复苏率、临床妊娠率、胚胎种植率和流产率等各项指标。结果:玻璃化冷冻组的平均移植胚胎数(2.2±0.5枚)显著少于程序化组(2.5±0.6枚)(P<0.05),复苏率(94.4%)、完整胚胎率(73.7%)、临床妊娠率(50.8%)和种植率(30.2%)显著高于程序化组(77.2%、44.3%、36.2%、21.1%)(P<0.05),而流产率和周期取消率组间均无统计学差异(16.6%vs 27.7%,1.3%vs 2.3%)(P>0.05)。程序化冷冻胚胎的种植率在完整胚胎(13.5%)和非完整胚胎(16.0%)组间无统计学差异(P>0.05);玻璃化冷冻完整胚胎组的种植率(30.4%)显著高于非完整胚胎组(20.1%)(P<0.05);而2种冷冻方法的流产率完整胚胎组(35.7%,15.1%)均显著高于非完整胚胎组(8.7%,2.9%)(P<0.05)。在玻璃化冷冻中,卵裂期胚胎组的各项指标与囊胚期组相比均无统计学差异(P>0.05)。结论:玻璃化冷冻法适用于人类胚胎的保存,对卵裂期和囊胚期胚胎有同样理想的保存效果和临床结局,玻璃化冷冻中,胚胎完整性对胚胎种植率起着重要的作用。  相似文献   

7.
冷冻前胚胎因素对冻融胚胎移植结局的影响   总被引:1,自引:0,他引:1  
目的:探讨冻融胚胎移植周期中冷冻前胚胎因素对临床结局的影响。方法:回顾分析本生殖中心2009年1月~9月的589个冻融胚胎移植周期,根据冷冻前受精方式、胚胎培养时间、胚胎卵裂球数目、冷冻前≥6细胞胚胎个数分组。结果:589例冻融移植周期中共解冻胚胎2185枚,复苏率为69.5%,临床妊娠率26.5%。不同受精方式的临床妊娠率分别为23.4%,33.2%,差异有统计学意义;D2胚胎和D3胚胎冷冻后复苏率和临床妊娠率差异有统计学意义(71.4%vs69.1%和20.2%vs30.1%);冷冻前胚胎≥6细胞和6细胞,两组的临床妊娠率(31.8%,22.0%)和卵裂球完全存活复苏率(23.7%,45.4%)比较,差异均有统计学意义;冷冻前3个及以上≥6细胞的胚胎复苏率最高为56.0%、卵裂球完全存活复苏率最低为20.9%,与冷冻前少于3个胚胎组相比差异有统计学意义。若冷冻前仅余1个≥6细胞胚胎,冷冻后复苏率显著高于仅余1个6细胞胚胎,但卵裂球完全存活复苏率显著降低;和仅余2个胚胎相比,组间临床妊娠率无统计学差异。结论:冷冻前≥6细胞胚胎的妊娠结局优于6细胞的胚胎;若冷冻前仅余1个6细胞的胚胎,虽然冻融后复苏率较低,但仍有妊娠的可能,因此仍然建议冻存这部分胚胎,提高患者的累积妊娠率。  相似文献   

8.
玻璃化冷冻活检后人胚胎的探索   总被引:1,自引:0,他引:1  
目的:探索玻璃化方法冷冻活检后人胚胎的可行性。方法:实验组中活检后的胚胎先后在含10%乙二醇平衡液和30%乙二醇加0.5mol/L蔗糖的玻璃化液中进行平衡,然后将胚胎置于冷冻薄膜上,直接在液氮中快速冷冻。复温时采用1mol/L浓度的蔗糖液。对照组中活检后的胚胎进行标准程序化丙二醇慢冻。结果:采用玻璃化冷冻技术后,活检后的人胚胎冻存率、完整率、卵裂球总体存活率、囊胚形成率均显著比使用标准程序化丙二醇慢冻方法提高(95%对15%,P<0.01;75%对9%,P<0.01;89%对24%,P<0.01;20%对2%,P<0.05)。结论:玻璃化冷冻可以显著提高活检后的卵裂期的人胚胎的冻存结局。  相似文献   

9.
陈曦  梁蓉  石程  王筠  田莉  沈浣 《生殖与避孕》2011,31(10):671-675
目的:探讨透明带薄化法激光辅助孵化技术对慢速冷冻和玻璃化冷冻卵裂期胚胎临床结局的影响。方法:回顾性分析复苏后至少有1个胚胎是完整存活的564例卵裂期冻融胚胎移植周期,根据胚胎移植前是否行激光辅助孵化,分为辅助孵化组(研究组)与非辅助孵化组(对照组),分别观察透明带薄化法激光辅助孵化技术对慢速冷冻胚胎及玻璃化冷冻胚胎的临床妊娠率、种植率及流产率的影响。结果:胚胎经慢速冷冻后,研究组胚胎种植率(19.5%)显著高于对照组(13.5%),差异有统计学意义(P<0.05),而临床妊娠率及流产率(37.9%vs 28.5%、15.5%vs 10.8%)无显著差异;胚胎经玻璃化冷冻后,研究组和对照组胚胎的临床妊娠率(38.0%vs 35.6%)、种植率(17.3%vs 15.9%)及流产率(7.6%vs 19.2%)相比较均无统计学差异;研究组中来源于2种冷冻方法的卵裂期胚胎的临床妊娠率(37.9%vs 38.0%)和种植率(19.5%vs 17.3%)无统计学差异(P>0.05)。结论:透明带薄化法激光辅助孵化能够提高慢速冷冻的卵裂期胚胎的种植能力,且不会增加其流产风险,但并不能提高玻璃化冷冻的卵裂期胚胎的种植能力。  相似文献   

10.
目的:比较以玻璃微细管为载体的玻璃化法和程序慢冻法冷冻保存人卵裂期胚胎的临床效果、妊娠结局及新生儿情况.方法:将接受体外受精-胚胎移植患者的剩余卵裂期优质胚胎进行玻璃化法或程序慢冻法冷冻,比较复苏后的胚胎存活率、种植率、妊娠率、流产率、活胎分娩率、出生缺陷率、新生儿平均出生体重及孕周.结果:玻璃化法移植的胚胎数目显著少于程序慢冻法(2.32±0.66个vs 2.51±0.60个,P=0.029),但胚胎种植率、临床妊娠率明显高于程序慢冻法(19.03%vs 10.74%,P=0.0005;34.40%vs 23.21%,P=0.0193).在妊娠周期中,两种冷冻方法的流产率、活胎分娩率、新生儿出生体重、孕周及新生儿出生缺陷率比较,差异均无统计学意义(P>0.05).结论:以玻璃微细管为栽体的玻璃化法能有效冷冻保存人卵裂期胚胎,其冷冻效率优于程序慢冻法,并且未见新生儿先天畸形.  相似文献   

11.

Objectives

To compare embryo survival, pregnancy and implantation rates after cryopreservation of human cleavage-stage embryos with slow-rate cryopreservation or vitrification.

Study design

262 patients, attending for assisted reproduction, were prepared for oocyte retrieval using standard controlled ovarian hyperstimulation protocols. Excess embryos were cryopreserved on day 3 either by vitrification, or slow-rate cryopreservation in a programmable freezer. Cycles of thawing were monitored for thaw efficiency, pregnancy and implantation rates.

Results

Clinical pregnancy and implantation rates were highly comparable between cycles in which day 3 embryos were thawed either after slow-rate cryopreservation or vitrification.

Conclusions

These data suggest that vitrification of human embryos during assisted reproduction cycles achieves comparable success rates to fresh cycles and therefore can be applied in the laboratory of assisted reproduction.  相似文献   

12.
Blastocyst culture has reduced the number of embryos transferred per cycle, whilst simultaneously creating new quandaries regarding supernumerary blastocyst cryopreservation. This retrospective study was undertaken to compare a slow freezing protocol to a vitrification protocol for cryopreservation of day 5 and day 6 human blastocysts. To demonstrate this, the survival, implantation rate and pregnancy rates were compared after thawing, assessment and embryo transfer of 86 consecutive day 5 and day 6 thawed blastocyst transfer cycles from January 1, 2002 to December 31, 2003. Seventy-one day 5 slow-frozen (SF) blastocysts were thawed and 59 embryos survived the thawing (83.1%). An average of 2.5 SF blastocysts was replaced per embryo transfer, resulting in a pregnancy rate of 16.7% (4/24). Concurrently, 41 vitrified (VIT) blastocysts were thawed and all 41 survived the thawing process (100%). An average of 2.0 VIT blastocysts was replaced per embryo transfer, resulting in a pregnancy rate of 50% (10/20). Survival, pregnancy and implantation rates of day 5 VIT blastocysts have significantly increased (P < 0.01, P < 0.02 and P < 0.01 respectively) over day 5 SF blastocysts. A similar trend was observed with day 6 blastocysts.  相似文献   

13.
Birth of a healthy baby following vitrification of human blastocysts   总被引:22,自引:0,他引:22  
OBJECTIVE: To assess vitrification of human blastocysts. DESIGN: Retrospective study of blastocyst vitrification. SETTING: A private clinic. PATIENT(S): Twenty couples with different types of infertility. INTERVENTION(S): Blastocysts were frozen with rapid vitrification and then transferred after thawing. We vitrified blastocysts using a modification of Ishimori's vitrification solution of ethylene glycol and dimethyl sulfoxide (VSED). MAIN OUTCOME MEASURE(S): After thawing, survival was defined by the embryo's development morphology after 6 hours or overnight culture. RESULT(S): Eighteen of 20 patients underwent treatment. Of 45 vitrified blastocysts, 36 survived, for a survival rate of 80% (36 of 45). The implantation rate was 21.9% (7 of 32), and the pregnancy rate (per embryo transfer cycle) was 33.3% (6 of 18). One of the pregnancies resulted in the delivery of a healthy baby. CONCLUSION(S): Supernumerary embryos were grown in culture to blastocysts, and the survival rate of vitrified-thawed blastocysts was the same as that for slow freezing of early stage embryos. Blastocyst vitrification should prove effective for clinical treatment. The present results strongly suggest that this rapid and successful vitrification procedure will replace conventional cryopreservation in the future.  相似文献   

14.
Vitrification technology has shown great promise for cryopreservation of human embryos. The majority of this work has been with blastocyst-stage embryos. This report describes initial clinical results following vitrification of human embryos on day 3 of culture at the 6- to 8-cell stage. A total of 236 embryos were cryopreserved on cryoloops using a vitrification protocol. Warmed embryos were cultured until day 5 before transfer to the patient. The post-warming survival rate was 85%. The clinical pregnancy rate was 44% (34/77), and the implantation rate was 20% (40/201). In transfers where at least one warmed embryo reached the blastocyst stage by the day of transfer, the clinical pregnancy rate was 58% (28/48). The cryoloop was an excellent vessel for ultra-rapid cryopreservation of embryos. This study supports the effectiveness of a dimethylsulphoxide/ethylene glycol cryoprotectant combination for vitrification of human embryos at the 6- to 8-cell stage.  相似文献   

15.
BACKGROUND: Vitrification has evolved into an established technique for cryopreservation of human blastocysts. However, it is still unclear whether the blastocysts developed from frozen embryos can be cryopreserved a second time by vitrification for further embryo transfer. CASE: A 31-year-old woman underwent a long-treatment protocol for ovarian stimulation. Twenty-seven mature oocytes were obtained, and 21 were fertilized with intracytoplasmic sperm injection. On day 3, 2 cleaved embryos were transferred, but no implantation occurred. The remaining 19 embryos were cryopreserved with the slow freezing method. Three months after oocyte retrieval, 5 frozen day 3 embryos were thawed, the surviving 2 were transferred, but no implantation occurred. Six months after oocyte retrieval, the remaining 14 frozen day 3 embryos were thawed and the surviving 12 cultured. On day 5, 2 embryos reached the expanded blastocyst stage and were transferred, but no implantation occurred. On day 6, 5 of the nontransferred embryos became expanded blastocysts and were cryopreserved again by vitrification. Eight months after oocyte retrieval, 2 recryopreserved day 6 blastocysts were warmed and transferred. Implantation resulted in a dizygotic twin pregnancy. The pregnancy resulted in delivery of normal, healthy male and female infants weighing 2,155 and 2,590 g at birth, at 36 weeks of gestation. CONCLUSION: The blastocysts developed from frozen embryos on day 6 can be recryopreserved by vitrification and have pregnancy potential after warming.  相似文献   

16.
OBJECTIVE: To evaluate the efficacy and efficiency of freezing cleaved human embryos through vitrification. DESIGN: Clinical study of vitrification of human embryos. SETTING: Assisted reproductive technology centers. PATIENT(S): Thirty-six patients undergoing IVF-ICSI treatment whose surplus embryos were frozen. INTERVENTION(S): Two hundred fifteen surplus embryos vitrified, subsequently thawed, and transferred in natural or controlled cycles. MAIN OUTCOME MEASURE(S): Embryo survival rate after thawing and resultant patient pregnancy rate. RESULT(S): From the 215 vitrified and thawed embryos, 106 survived, with an overall embryo survival rate of 49.3%. The survival rate was higher when embryos were vitrified at the eight-cell stage compared with at the six to seven-cell and six-cell stages (79.2%, 39.7%, and 21.1%, respectively). On average, 2.9 +/- 1.2 embryos per patient were transferred, resulting in 11 pregnancies (30.5%), with an implantation rate of 10.4% per embryo transferred. CONCLUSION(S): Ultrarapid embryo freezing by vitrification of eight-cell stage embryos is a reliable method, as evidenced by high rates of embryo survival and pregnancy, making it a superior alternative to the conventional slow-cooling method.  相似文献   

17.
Application of vitrification to human embryo freezing   总被引:4,自引:0,他引:4  
To solve the problem of multiple pregnancies during the in vitro fertilization (IVF) and embryo transfer procedure, excess embryos must be cryopreserved for embryo transfer in future. We applied the vitrification method to cryopreservation of human embryos. A total of 31 frozen-thawed embryo transfer cycles were analyzed at the Yamagata University Hospital, Yamagata, Japan. The patients were introduced to IVF treatment and had an excess of valuable embryos to be frozen after the transfer of three fresh embryos that did not result in establishing a pregnancy. Excess human 8- to 16-cell stage embryos were exposed to vitrification solution and then frozen in liquid nitrogen. The cryoprotectant was removed by washing the embryos in media containing different concentrations of cryoprotectant. Three days after LH surge and/or 2 days after ultrasonographic ovulation the embryos were transferred. The rate of poor quality embryos significantly increased and the rate of good quality embryos decreased after thawing the embryos frozen by the vitrification method. In menstrual cycles with good quality embryo transfer, a higher rate of pregnancies was established than in the cycles in which fair or poor quality embryos were the highest grade of embryos transferred into the uterus. In total, 5 pregnancies were established from 31 embryo tansfers; 4 pregnancies were in cycles associated with the transfer of good quality embryos, and 1 pregnancy was in a cycle in which the highest grade of embryo was fair. When compared with slow embryo freezing methods, vitrification has marked advantages for clinical application in terms of cost and time. Vitrification will be an alternative method for embryo freezing.  相似文献   

18.
Vitrification is a cryopreservation strategy where cells are converted into a glass-like amorphous solid which is free of any crystalline structure. Such process is achieved by a combination of high concentration of cryoprotectant and an extremely high cooling rate. In the last years, survival rates of up to 80% after thawing and pregnancy rates of almost 30% could be achieved after transfer of vitrified embryos at the zygote, cleavage, morula and blastocyst stages. Also deliveries of healthy babies have been reported numerous times. To this day, a limited interest in this technique can be noted. The explanation may lye in the apprehension of many ART units regarding exposure of embryos to high concentrations of cryoprotectants and storage in non sterile conditions. The aim of the first part of this article, is to analyse if such fears are justified on the basis that vitrification mimics conditions already in use for many years in slow-cooling procedures where cells are plunged into liquid nitrogen at around -30 degrees C and secondly since storage of embryos are now possible in high aseptic conditions. In the second part, results on survival after thawing, pregnancy rates and baby take home rates of vitrified embryos will be presented and the problems associated with vitrification of blastocysts will be discussed.  相似文献   

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