激光辅助孵化在反复种植失败及冻融胚胎移植患者中的应用

目的探讨激光辅助孵化(laser-assisted hatching,LAH)对反复种植失败及冻融胚胎移植(frozen-thawed embryos,FET)患者的临床妊娠结局的影响。方法收集反复种植失败的患者100例,随机分为LAH组1与对照组1,FET患者200例,随机分为LAH组2与对照组2,LAH组1与LAH组2患者移植前进行LAH。结果 LAH组1患者的临床妊娠率及胚胎种植率均高于对照组1,(分别是44%vs 28%,P>0.05,25%vs 11.33%,P=0.003),两组患者的早期流产率及双胎率均无明显差异。LAH组2患者的临床妊娠率及胚胎种植率与对照组2比较均无明显差异(分别是37%vs 38%,P=0.884;19.17%vs16.50%,P=0.50)。LAH组2患者的早期流产率及双胎妊娠率高于对照组2,但无统计学意义。结论 LAH可改善反复种植失败患者的妊娠结局;对年轻的FET患者妊娠结局无明显影响,不宜对所有FET患者常规进行LAH治疗。

The impact of laser-assisted hatching on patients with recurrent implantation failure after in vitro fertilization and frozen/thawed embryos transfer

Objective To determine whether laser-assisted hatching can improve clinical outcome of patients with recurrent implantation failure after in vitro fertilization and frozen/thawed embryos transfer. Methods One hundred patients with recurrent implantation failure were divided equally into LAH1 and controll groups; Two hundred patients with frozen-thawed embryos were divided equally into LAH2 and control2 groups. On the day of embryo transfer, the zona pellucida of the selected embryos in the LAH groups were thinning by using laser system. Results In the patients with recurrent implantation failure, the rates of clinical pregnancy and implantation in LAH1 group higher than witch in controll group （44% VS 28%, P〉0.05, 25% vs 11.33%, P=0.003 respectively）. The early abortion and twin pregnancy rates were similar for them. In the patients with frozen-thawed embryos, the clinical pregnancy and implantation rates were similar for the LAH and control groups（37% vs 38%, P=0.884; 19.17% vs 16.50%, P=0.50 respectively）. The early abortion and twin pregnancy rates were higher in the LAH2 group compared with the control2 group, but statistics compare no significant differences. Conclusion The LAH improved the implantation rate in patients with re- current implantation failure. LAH did not improve the implantation rate of FET cycles with younger patients , And should not be performed routinely in all frozen-thawed embryos at the cleavage stage.