卵裂球受损对冻融胚胎移植周期临床结局的影响

目的探讨卵裂球受损对冻融胚胎移植周期临床结局的影响。方法回顾分析181个冻融胚胎移植周期,了解胚胎级别与冷冻受损的关系,分析受损程度(完整存活、受损率≤20%和>20%组)和移植平均≥6、<6细胞胚胎对妊娠率和种植率的影响。结果1、2、3级胚胎存活率差异显著(P<0.05),损伤率差异非常显著(P<0.001)。完整存活胚胎、受损率≤20%及>20%胚胎组的临床妊娠率、种植率均存在显著性差异(P<0.05,P<0.01),移植≥6细胞胚胎组的临床妊娠率、种植率显著高于<6细胞胚胎组(P<0.05)。结论胚胎卵裂球受损率评价胚胎受损程度优于胚胎存活率。在冻融胚胎移植周期,胚胎质量、移植时胚胎细胞期和受损程度是影响妊娠率和种植率的胚胎学因素。

The effect of blastomere damage rate on the clinical outcome in frozen-thawed embryo transfer cycles

Objective: To investigate the effects of the blastomere damage on the clinical outcome in frozen-thawed embryo transfer(FET) cycles.Methods: A retrospective analysis was performed in our center on 181 frozen-thawed embryo transfer cycles.The relationship between embryo quality and the damage rate of blastomere cells was analyzed.Pregnancy rate and implantation rate of transferred embryos at different grades of damage(fully intact embryo,embryo with ≤20% and >20% blastomere cells damaged) were evaluated,and the pregnancy and implantation rates of transferred embryos with six or more cells and less than six cells were compared.Results: Embryo survival rate and blastomere cell damage rate were significantly different between grade1,2 and 3 embryo groups,respectively (P<0.05 for the survival rate and P<0.001 for the damage rate).Higher clinical pregnancy and implantation rates were observed when all transferred embryos were classified as fully intact blastomere,as compared to those of embryos with ≤20% and >20% blastomere cells damaged(P<0.05 and P<0.01,respectively).The clinical pregnancy and implantation rates of transferred embryos with six or more cells were significantly higher than those of embryos with less than six cells(P<0.05).Conclusions: The damage rate of blastomere cells is better for the evaluation of the extent of embryo damage than embryo survival rate.Embryo quality,development stage of transferred embryo and the extent of blastomere damage are the most important embryological factors influencing the pregnancy rate and implantation rate in FET cycles.