囊胚发育速度对冻融移植结局的影响

目的比较D5和D6的冻融囊胚移植后的种植率、临床妊娠率、活产率和流产率,为囊胚复苏日的胚胎选择提供指导。方法回顾性分析2012年3月~12月在北京协和医院辅助生殖中心进行复苏囊胚移植的178个周期的患者资料,按照冷冻前形成囊胚的时间(D5或D6)进行分组,比较两组的种植率、临床妊娠率、活产率和流产率。结果共复苏178个周期,复苏囊胚303个,复苏后所有囊胚腔均扩张,复苏成活率100%。平均移植囊胚数(1.70±0.46)个。178个周期均进行了胚胎移植,囊胚种植率为59.4%(180/303),临床妊娠率70.8%(126/178),失访5例,活产率55.6%(99/178),流产率17.5%(22/126)。D5冻融囊胚的临床妊娠率(78.0%),显著高于D6冻融囊胚的临床妊娠率(64.6%)(P0.05)。D5冻融囊胚的种植率(64.3%)、活产率(63.4%)高于D6冻融囊胚的种植率(51.0%)和活产率(49.0%),但差异无统计学意义(P值分别为0.089和0.053)。D5的流产率(14.3%)要低于D6(20.6%),但差异无统计学意义(P=0.324)。结论 D5和D6的囊胚冷冻复苏后均有较好的种植率、临床妊娠率和活产率,但是D5的囊胚临床结局要优于D6的囊胚,囊胚复苏移植时可以优先考虑选择D5的胚胎。

Effect of blastocyst development speed on pregnancy outcome in frozen-thawed blastocyst transfer cycle

Objective. To compare the implantation rate, pregnancy rate, live birth rate and miscarriage rate following transfer of frozen-thawed embryos on day 5 and on day 6. ：Methods： This retrospective study included 178 frozen-thawed blastocysts transfer cycles in our productive center from March 2012 to December 2012. The patients were grouped by the day of blastocyst formed（day 5 or day 6）. And the implantation irates,pregnancy rates,live birth rates and miscarriage rate f were compared between the two groups. Results： A total of 303 blastocysts were warmed with 100% survival rate in 178 frozen-thawed blastocyst transfer cycles. The implantation rate,pregnancy rate,live birth rate and miscarriage rate were 59.4% ,70.8% ,55.6% and 17.5% respectively. The pregnancy rate was significantly higher in blastocysts cryopreserved on day 5 group than that on day 6 group （P = 0. 049）. There were no differences in implantation rate,live birth rate and miscarriage rate between the two groups（P〉0. 05）. Conclusions. The clinical outcome of blastocyst on day 5 is better than that of embryos on day 6. The blastocysts on day 5 have higher inherent viability than blastocysts on day 6.