卵裂期胚胎提前解冻培养过夜对冻融移植周期临床结局的影响

目的探讨玻璃化冻融周期中卵裂期胚胎当天解冻移植和提前1天解冻过夜培养后移植对妊娠结局的影响。方法选择武汉大学中南医院生殖医学中心2015年1月-2018年6月的414个冻融卵裂期胚胎移植周期进行回顾性分析。根据胚胎解冻和培养的时间点,分为当日解冻组(A组,207个周期)和提前解冻组(B组,207个周期);根据患者的年龄,A组B组又分别分成3个亚组,即年龄<30岁(A1,B1);年龄31~35岁(A2,B2)和年龄>35岁(A3,B3),比较各组间的种植率、临床妊娠率、活产率及流产率等的差异。结果A1组与B1组的临床妊娠率、种植率、活产率及流产率分别为47%vs 65.3%,30.3%vs 45.4%,36.4%vs 52.3%,15%vs 13.9%;A2组与B2组的临床妊娠率、种植率、活产率及流产率分别为54.8%vs 71.8%,38.2%vs 51.5%,46.6%vs 60.7%,21.9%vs17.6%;A3组与B3组的临床妊娠率、种植率、活产率及流产率分别为38.2%vs 52.9%,24.8%vs 37.3%,25%vs 36.8%,35.5%vs 29.2%;提前解冻在不同年龄组均可显著改善妊娠结局,差异均有统计学意义(P<0.05)。此外,无论是否提前解冻,年龄>35岁组的活产率均显著低于≤30岁组和31岁~35岁组(P<0.05),而妊娠率和种植率较其他两组亦呈现降低趋势,但差异无显著性。结论冻融卵裂期胚胎提前解冻培养后再进行移植能改善妊娠结局,并且随着女性年龄的增高,活产率均会随之下降。

Overnight post-thaw culture of cleavage-stage embryos improves the pregnancy outcome of frozen-thawed embryo transfer cycles

Objective:To investigate the effects of overnight post-thaw culture of embryos on the clinical pregnancy outcome in frozen-thawed embryo transfer cycles.Methods:A retrospective analysis was performed involving 414 patients,who underwent frozen-thawed cleavage stage embryo transferred at the Reproductive Medicine Center of Zhongnan Hospital of Wuhan University from June 2015 to June 2018,namely 414 frozen-thawed cleavage-stage embryo transfer cycles.According to the time point of thawing,it was divided into the common thawing group(207 cycles in group A)and the beforehand thawing group(207 cycles in group B).According to the age of the patients,group A and B were subdivided into 3 groups respectively,named A1,B1:age<30 Years old;A2,B2:age from 31 to 35 years old;and A3,B3:age>35 years old,and then the pregnancy outcome of those groups were analyzed.Results:The clinical pregnancy rates in group A1 vs group B1,group A2 vs group B2,group A3 vs group B3 were 47%vs 65.3%,54.8%vs 71.8%,38.2%vs 52.9%respectively.The implantation rates in those groups were 30.3%vs 45.4%,38.2%vs 51.5%,24.8%vs 37.3%respectively.And when it comes to the birth rates in the above groups,they were 36.4%vs 52.3%,46.6%vs 60.7%,25%vs 36.8%respectively.The abortion rate were 15%vs 13.9%,21.9%vs17.6%,35.5%vs 29.2%respectively.One-day-in-advance thawing of embryo was shown to significantly improve the pregnancy outcome,when the clinical pregnancy rate,the implantation rate and the live birth rate were considered(P<0.05).Meanwhile,in the group>35 years,the live birth rate was significantly lower than that in the groups 31-35 years old and≤30 years old(P<0.05).Conclusion:Thawing of cleavage embryos one day in advance can improve the pregnancy outcome of frozen-thawed cylces.Moreover,as the age of women increases,the live birth rate will decrease.