雌孕激素替代法准备子宫内膜在冻融胚胎移植中的临床研究

目的:探讨雌孕激素替代法作为子宫内膜准备方法对冻融胚胎移植(FET)妊娠结局的影响.方法:对我中心应用雌孕激素替代法作为子宫内膜准备方法拟进行FET的129例患者(140个周期)进行回顾性分析,观察冷冻复苏移植的效果.结果:140个雌孕激素替代周期中进行FET 132个周期,周期取消率5.7%(8/140).移植周期妊娠率38.6%(51/132),胚胎种植率19.6%(70/357).妊娠组与非妊娠组在雌二醇水平、子宫内膜厚度、胚胎复苏存活率及完整存活率上比较,差异均无统计学意义(P>0.05);但年龄及优质胚胎率比较,差异有统计学意义(P<0.05).结论:对排卵障碍患者采用雌孕激素替代法准备子宫内膜,进行FET是一种有效、依从性好的方法.影响FET妊娠率的主要因素可能是患者的年龄及可移植的优质胚胎.     

PCOS患者不同子宫内膜准备方案冻胚移植结局分析

目的:探讨冻胚移植失败PCOS患者再次冻胚移植内膜准备的最佳方案。方法:回顾分析2011年8月~2013年7月在青岛市妇女儿童医院生殖中心行人工周期准备内膜冻融胚胎移植的PCOS患者的临床资料,对移植失败或因突破性出血取消周期尚有冻存胚胎的162例PCOS患者实施再次冻胚移植。将患者随机分为GnRHa+人工周期(降调节+人工周期组)、人工周期和诱导排卵方案3组,观察3组患者的年龄、体重指数(BMI)、不孕年限、胚胎冻存时间、突破性出血率、周期取消率、优质胚胎率、移植胚胎数、移植日子宫内膜厚度及类型、内膜增殖时间、内膜转化日血清雌激素浓度、种植率、妊娠率、流产率、异位妊娠率。结果:降调节+人工周期组和诱导排卵组无一例发生突破性出血。诱导排卵组内膜转化日E2平均水平为(2827.33±1148.49)pg/ml,高于其他2组,差异有统计学意义(P0.05);平均子宫内膜厚度为(9.14±0.90)mm,较其他2组增高,但差异无统计学意义(P0.05)。诱导排卵组的B级以下内膜所占比例最低,为9.76%,但差异无统计学意义(P0.05)。降调节+人工周期组的临床妊娠率和着床率分别为50.94%和22.54%,诱导排卵组分别为53.66%和22.77%,与人工周期组(31.03%,13.07%)比较,差异均有统计学意义(P0.05)。结论:对于PCOS患者,初次冻胚移植失败后再次冻胚移植时采用降调节+人工周期方案或诱导排卵方案,可降低突破性出血率,减少周期取消,提高妊娠率和着床率。     

多囊卵巢综合征患者冻融胚胎移植3种内膜准备方案的临床结局比较

目的:比较多囊卵巢综合征(PCOS)患者冻融胚胎移植(FET)周期3种不同内膜准备方案的临床妊娠结局,探讨适合PCOS患者的子宫内膜准备方案.方法:回顾性分析127例PCOS患者冻融胚胎移植周期的临床资料,比较激素替代组(HRT组)、HMG诱导排卵组(HMG组)和来曲唑诱导排卵组(LE组)的子宫内膜厚度、临床妊娠率、种植率、早期流产率、活产率.结果:HRT组47例,43个移植周期,HMG组35例,32个移植周期,LE组45例,42个移植周期,3组年龄、不孕年限、体重指数、血清睾酮水平差异无统计学意义(P>0.05),周期取消率、子宫内膜厚度、复苏后胚胎存活率、平均移植胚胎个数,移植优质胚胎率、周期临床妊娠率、周期种植率、早期流产率、活产率亦差异无统计学意义(P>0.05).结论:PCOS患者FET周期3种子宫内膜准备方案均能获得良好的妊娠结局,来曲唑诱导排卵可作为PCOS患者FET周期内膜准备方案之一,应个体化选择临床用药方案.     

薄型子宫内膜新鲜胚胎和冻融胚胎移植妊娠结局比较

目的探讨在薄型子宫内膜患者中新鲜胚胎移植与冻融胚胎移植(FET)妊娠结局的差异。方法回顾性分析接受体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)治疗采用长方案胚胎移植h CG注射日与冻融周期胚胎移植内膜转化日的内膜厚度≤7 mm的患者共592个周期的临床资料。将移植周期按胚胎是否冻融分为新鲜胚胎移植组(n=173)和FET组(n=419)。比较组间的胚胎种植率、临床妊娠率、流产率、多胎率和异位妊娠率有无差异。结果新鲜胚胎移植组患者平均移植胚胎(2.1±0.4)枚,与FET组患者平均移植胚胎(2.1±0.5)枚比较,组间有统计学差异(P0.05);按照移植胚胎数分为3个亚组,新鲜胚胎移植组1枚胚胎者,妊娠率为7.7%,2枚者为30.2%,3枚者为23.8%;FET组1枚胚胎者15.6%,2枚者为34.9%,3枚者为41.6%,新鲜胚胎移植组与FET组间差异均无统计学意义(P0.05)。组间着床率、流产率、异位妊娠率等结果也均无统计学差异(P0.05)。移植3枚胚胎新鲜组多胎率(80.0%)高于FET组(29.7%)(P0.05)。新鲜胚胎移植组多胎率3个亚组间有统计学差异(P0.05),FET组妊娠率和流产率3个亚组间均有统计学差异(P0.05)。将移植胚胎数作为协变量,纳入Logistics回归模型对结果变量进行分析,说明周期类型与临床妊娠率间无显著相关性(OR=0.726,95%CI=0.504~1.104)。结论子宫内膜厚度≤7 mm的薄型内膜患者新鲜胚胎移植和FET妊娠结局相似,选择新鲜周期移植不影响妊娠结局并可缩短治疗周期,降低总费用。     

自然周期使用hCG诱导排卵对冻融胚胎移植临床结局的影响

目的:自然周期和hCG诱导排卵的自然周期内膜准备对冻融胚胎移植临床结局的影响。方法:377例准备冻融胚胎移植(FET)者均采用监测排卵准备内膜,其中182例为自然周期组,195例为hCG诱导排卵自然周期组。比较组间的一般临床资料、冷冻胚胎数、解冻胚胎数、移植日内膜厚度、临床妊娠率、胚胎种植率和流产率。结果:自然周期组的临床妊娠率明显低于hCG诱导自然周期组,差异有统计学意义(P=0.01),胚胎种植率亦低于hCG诱导组,但差异无统计学意义(P=0.07)。流产率组间无统计学差异(P=0.20)。结论:自然周期使用hCG诱导排卵有可能提高冻融胚胎移植的临床妊娠率。     

影响冻融胚胎移植妊娠结局的相关因素分析

目的:探讨影响冻融胚胎移植(FET)妊娠结局的相关因素。方法:回顾性分析324个周期行FET患者的临床资料,分析患者年龄、体质量指数(BMI)、移植日子宫内膜厚度、内膜准备方案、移植胚胎数等相关因素对FET妊娠结局的影响。结果:324个周期共解冻胚胎727个,复苏成活720个(99.0%),临床妊娠144例(44.4%),胚胎植入196例(27.2%)。其中自然内膜准备周期组和激素替代内膜准备周期组患者年龄、不孕年限、基础卵泡刺激素(bFSH)、基础黄体生成素(bLH)、基础雌二醇(bE2)、复苏胚胎数、移植胚胎数、移植日子宫内膜厚度、胚胎种植率及临床妊娠率组间均无统计学差异(P0.05)。年龄≤35岁组的临床妊娠率高于年龄35岁组,差异有统计学意义(P0.05);BMI≥24.0 kg/m2的肥胖组临床妊娠率与正常体质量(BMI=18.5~23.9 kg/m2)组无统计学差异(P0.05);移植日子宫内膜厚度≥7 mm组的临床妊娠率高于移植日子宫内膜厚度7 mm组,但差异无统计学意义(P0.05);各移植胚胎数组间临床妊娠率无统计学差异(P0.05)。结论:年龄是影响FET临床结局的重要因素,内膜准备方案、BMI、移植日内膜厚度、移植胚胎数对冻融胚胎移植临床结局无影响。     

过夜培养对冻融胚胎移植周期妊娠结局的影响

目的:探讨冻融胚胎移植周期中胚胎复苏时间对妊娠结局的影响。方法:回顾分析行冻胚移植(FET)的206对夫妇共248个周期,根据解冻时间的不同分为A组(对照组):排卵后2～3d或注射黄体酮3～4d后解冻,培养2h移植;B组(实验组):提前1d解冻,培养20h移植。比较各组间患者一般资料、复苏胚胎存活率、完整率、临床妊娠率、胚胎着床率和流产率。结果:A、B组间患者年龄、不孕年限、不孕原因、继发不孕所占比例、第3日冷冻胚胎比例、冷冻胚胎数、移植时内膜厚度、优胚数、胚胎复苏存活率、完整率、平均移植胚胎数均未见差异,而B组临床妊娠率和胚胎着床率显著高于A组(46.36%、25.29%vs30.88%、13.54%,P<0.05),组间流产率未见差异。过夜培养后有胚胎生长组临床妊娠率高于无生长组(49.47%vs26.67%,P>0.05)。结论:冻胚移植周期中提前解冻可以改善妊娠结局。     

影响冷冻胚胎移植妊娠率相关因素分析

目的: 探讨影响冷冻胚胎移植妊娠率的相关因素。 方法: 对129个接受冷冻胚胎移植患者的临床资料进行回顾性分析。结果: 129个冷冻胚胎移植周期,临床妊娠率27.1%,胚胎种植率12.8%;三种不同移植方案、常规体外受精(IVF)、单精子卵母细胞浆内注射(ICSI)所冻存的胚胎移植临床妊娠率无显著性差异(P>0.05)。<30、30~34、35~44岁三个年龄组胚胎种植率有显著差异(P<0.05);临床妊娠率以30~34岁组为最高(38.6%),35~44岁组明显下降(13.6%),三年龄组比较有显著性差异(P<0.05)。移植≥2个胚胎的子宫内膜厚度、平均移植胚胎数、累积胚胎评分、累积胚胎评分/胚胎移植数以及至少移植有1个4-细胞I级胚胎者,妊娠组与非妊娠组均有显著性差异(P<0.01)。 结论:患者的年龄、子宫内膜厚度、移植胚胎数目、胚胎形态及生长速率是影响冷冻胚胎移植妊娠率的重要因素。     

阿托西班对激素替代周期解冻胚胎移植妊娠结局的影响

目的探讨在行激素替代周期冻融胚胎移植的患者中,阿托西班对移植前有子宫内膜异常蠕动波的患者妊娠结局的影响。方法回顾性队列研究分析172例行激素替代周期冻融胚胎移植患者的临床资料,根据移植前日观察子宫内膜是否有异常蠕动,将有子宫内膜异常蠕动者归为A组(104例),并依据是否移植日使用阿托西班分为治疗组(A1,63例)和对照组(A2,41例),将没有子宫异常蠕动者归为B组(68例);分别比较各组的胚胎着床率、临床妊娠率、异位妊娠率及流产率。结果 A组和B组在一般资料及流产率、异位妊娠率差异均无统计学意义(P0.05);A1组的胚胎着床率(41.18%)和临床妊娠率(46.03%)均明显高于A2组(27.42%,26.83%),差异均有统计学意义(P=0.046,P=0.049);B组的胚胎着床率及临床妊娠率(39.82%,45.59%)均明显高于A2组(27.42%,26.83%),差异也均有统计学意义(P=0.049,P=0.049)。结论子宫内膜的异常蠕动可能会影响激素替代周期冻融胚胎移植的妊娠结局,而移植前给予阿托西班治疗能有效抑制内膜的异常蠕动,改善子宫内膜容受性,提高着床率和临床妊娠率。     

冻融胚胎移植周期中胚胎因素的分析研究

目的:分析冻融胚胎移植周期中胚胎卵裂球损伤程度与有丝分裂的恢复对于临床结局的影响。方法:171例患者共进行冻融胚胎移植206个周期,采用慢速冷冻法冻存d3胚胎,快速解冻法复苏后继续培养4h后移植,根据复苏后卵裂球的损伤程度分为完整组、混合组和损伤组,另根据复苏后4h胚胎进行分裂的情况分为分裂组,混合组和未分裂组,比较各组间的临床妊娠率和单胚着床率。结果:206个周期共复苏胚胎632枚,复苏存活率85.44%(540/632),移植胚胎508个,周期妊娠率36.41%(75/206),单胚着床率19.88%(101/508),完整组与损伤组间、分裂组与未分裂组间的临床妊娠率和单胚着床率都有显著性差异(P<0.05)。结论:冻融胚胎移植周期中胚胎卵裂球的损伤程度与有丝分裂的恢复是影响临床结局的重要因素。     

卵裂球数量及胚胎碎片对人冻胚卵裂球存活状况的影响

目的:探讨卵裂球数量及胚胎碎片对人冻胚卵裂球存活状况的影响。方法:取110例FET(frozen embryo transfer)周期的冻融胚胎,根据卵裂球数量及胚胎碎片分为5组:6～8细胞无碎片组(A组,n=102),4～5细胞无碎片组(B组,n=54),6～8细胞<10%碎片组(C组,n=75),4～5细胞<10%碎片组(D组,n=57),6～8细胞10%～25%碎片组(E组,n=28)。计算各组的胚胎存活率、卵裂球全存活率及卵裂球全死亡率。结果:110个FET周期共解冻胚胎316枚,复苏率68.7%。相同胚胎碎片条件下,6～8细胞与4～5细胞两组间胚胎存活率、卵裂球全存活率、卵裂球全死亡率均无显著差异(P>0.05)。6～8细胞胚胎中,碎片越多,胚胎存活率越低,卵裂球全死亡率越高(P<0.01),而卵裂球全存活率无差异(P>0.05);4～5细胞胚胎中,碎片越多,胚胎存活率(P<0.05)、卵裂球全存活率越低(P<0.01),而卵裂球全死亡率无差异(P>0.05)。结论:胚胎碎片是影响人冷冻胚胎中卵裂球存活状态的重要因素,而卵裂球数量对卵裂球存活无明显影响。     

The factors affecting the outcome of frozen-thawed embryo transfer cycle

ObjectiveTo determine the impact of the clinical and embryological factors on the pregnancy outcome of frozen–thawed embryo transfer.Materials and MethodsThe data of 247 frozen–thawed embryo transfer cycles were assessed at Royan Institute from March 2006 to March 2008. Appropriate statistical analysis was performed using Student t test and Chi-square or Fisher exact test. Forward logistic regression was done to predict the individual impact of factors on the success of frozen embryo transfer.ResultsAccording to our results, 1,523 frozen embryos were thawed with a survival rate of 79.8%. The overall chemical and clinical pregnancy rates per embryo transfer cycle were 28.1% and 26.3%, respectively. A total of 71 gestational sacs were implanted (7.9%). The pregnancy outcome was higher in women who were stimulated with the gonadotrophin releasing hormone agonist long protocol, treated by a combination of follicle stimulating hormone and luteinizing hormone, who had endometrial thickness greater than or equal to 8 mm on the embryo transfer day, and who had positive fresh-cycle pregnancy test.ConclusionProtocol type, gonadotrophin preparations, fresh-cycle outcome, endometrial thickness and the numbers of obtained oocytes, embryos, and high-quality thawed embryos transferred are the factors affecting pregnancy outcome of frozen–thawed embryo transfer.     

Can we improve implantation by cancellation of fresh embryo transfer?

Single embryo transfer is becoming increasingly popular in IVF/ICSI. More IVF/ICSI cycles therefore include freezing of high quality embryos, and the cumulative effect of such cycles becomes more important. To improve the results obtained using frozen–thawed embryos, the predictive value of embryo and patient characteristics such as ovarian reserve, hormone levels and age play an important role in both cases whether the women treated with oestradiol/progesterone or undergo natural cycle transfer. Although, embryo quality indicators revealed sometime morphologically and numerically inferior embryo cohorts after cryopreservation, the clinical pregnancy rate is higher in cycles using thawed embryos compared with fresh. Moreover, subsequent logistic regression analysis controlled for differences in embryo quality and revealed significantly greater probability of clinical pregnancy with thawed embryos when compared with fresh, suggesting a negative effect of ovarian stimulation on endometrial receptivity. The aim of this study is to discuss an idea of cancellation of a fresh embryo transfer and put on an alternative method which is the frozen thawed embryo.     

Cumulative pregnancy rates after transfer of fresh and thawed embryos

Frozen-thawed embryo transfer is an effective procedure that allows further possibilities of pregnancy in addition to those obtained after the fresh in vitro fertilization (IVF). In our follow-up study we analysed all fresh embryo transfer procedures and every frozen-thawed embryo transfer performed from January 2000 to December 2001 evaluating the cumulative pregnancy rates. The study population was divided into two groups according to the female age: <38 years (group I) and >38 years (group II). All the best embryos were chosen for transfer and all the supernumerary good quality embryos were cryopreserved on the day of transfer. The embryos were then thawed and manipulated using a new technique. In group I, 527 patients (619 cycles) underwent fresh embryo transfer and in 232 of them (238 cycles) the embryos were frozen (44% per patients and 38.4% per cycle). In group II, 156 patients (193 cycles) underwent fresh embryo transfer and in 14 of them (15 cycles) the embryos were frozen (9% per patient and 7.8% per cycle). The pregnancy rate of group I patients that had their supernumerary embryos frozen (232 patients and 238 cycles) was 47.4% per cycle and 48.7% per patient whereas in the same population of group II patients (14 patients and 15 cycles) the clinical pregnancy rate was 35.7% per cycle and 38.5% per patients. The cumulative clinical pregnancy rate after transfer of fresh and thawed embryos was: group I, 74% per cycle and 76% per patients; group II, 42.8% per cycle and 46.1% per patient. Frozen-thawed embryo transfer is a cost-effective practice.     

Effect of blastomere loss on the outcome of frozen embryo replacement cycles

OBJECTIVE: To assess the impact of survival of cryopreservation and thawing with all blastomeres intact on the outcome of frozen embryo replacement (FER) cycles. DESIGN: Prospective observational study. SETTING: University-affiliated tertiary referral assisted conception unit. PATIENT(S): The number of intact blastomeres before cryopreservation and after thawing was prospectively recorded in 1,687 cleavage-stage embryos thawed in 377 FER cycles. The cycles were categorized into two groups: group A (n = 184) included cycles in which all embryos transferred survived the cryopreservation and thawing process with all their original blastomeres intact; group B (n = 193) included cycles in which embryos transferred included at least one partially damaged embryo that has lost up to 50% of its original blastomere number. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Pregnancy and embryo implantation rates. RESULT(S): Groups A and B were comparable with respect to mean age at cryopreservation, mean number of oocytes retrieved and fertilized normally in the fresh cycle, and mean age at frozen transfer. No significant difference was found between the two groups with regard to mean number of frozen and thawed embryos per cycle and mean endometrial thickness reached before P supplementation. More embryos were transferred per cycle in group B than group A (2.4 +/- 0.6 vs. 2.1 +/- 0.6, respectively). However, the pregnancy and clinical pregnancy rates per cycle were significantly higher in group A than in group B (39.1% and 28.3% vs. 22.8% and 13.5%, respectively). The implantation rate was also higher in group A than in group B (17.3% vs. 8.1%, respectively). CONCLUSION(S): FER cycles in which all embryos transferred remained fully intact at thawing achieve a better outcome than those with at least one partially damaged embryo.     

胚胎冷冻及复苏移植120个周期临床效果分析

目的探讨冷冻胚胎复苏移植后的妊娠结局。方法2003年1月至2007年5月,对2～4细胞期胚胎进行慢速冷冻保存,快速复苏及移植,共有88例患者在哈尔滨医科大学第一临床医学院进行了120个周期的冷冻胚胎复苏移植,观察冷冻复苏移植的效果。结果复苏胚胎370个,存活316个,完整存活胚胎232个,移植316个胚胎,临床妊娠39例,妊娠率为32.5%(39/120)。胚胎种植率16.5%(52/316)。比较妊娠组与非妊娠组在年龄、雌二醇水平、子宫内膜厚度、胚胎复苏存活率及完整存活率上差异均无显著性意义(P>0.05),优质胚胎率差异有极显著性意义(P<0.01)。结论优质胚胎是移植后获得妊娠的关键,采用冻融胚胎移植技术可以提高辅助生殖技术的累计妊娠率。     

Impact of retained embryos on the outcome of assisted reproductive technologies

OBJECTIVE: To assess the impact of embryo retention in the embryo transfer catheter followed by "immediate" retransfer on pregnancy outcome in women undergoing assisted reproduction. DESIGN: Retrospective analysis of embryo transfer following in vitro fertilization. SETTING: Assisted reproductive technology practice in a university in vitro fertilization program. PATIENT(S): In vitro fertilization charts for 1,812 embryo transfer cycles representing 1,139 patients between January 1997 and March 2002 were reviewed. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Pregnancy rate, implantation rate, delivery rate. RESULT(S): Three embryo transfer cycles were excluded from analysis because of missing data, leaving 1,364 embryo transfers during oocyte recovery cycles and 445 embryo transfer cycles using thawed embryos. Seventy-one embryo transfers (3.9% of all transfers) were complicated by finding retained embryos after the initial embryo transfer-all retained embryos were immediately retransferred. There was no difference in the frequency of retained embryos during oocyte retrieval versus thawed embryo cycles. The pregnancy, implantation, and delivery rates per embryo transfer were not negatively affected by embryo(s) retained in the transfer catheter. Age, fresh versus frozen embryo, use of ultrasound during the procedure, or transferring physician did not influence pregnancy outcome. CONCLUSION(S): Immediate retransfer of embryos retained in the catheter following the initial transfer attempt did not have an adverse effect on pregnancy outcome.     

Clinical evaluation of frozen/thawed embryo transfer following transport of oocytes and embryos

Background and Aims  We evaluated the efficacy of the transport oocyte/embryo frozen/thawed embryo transfer method, in which oocytes or embryos were transported from satellite clinics to the main assisted reproductive technology (ART) center, and surplus embryos were placed in cryopreservation. Methods  We evaluated 41 cycles in 34 patients in the transport oocyte group (TO group). In the TO group the oocytes were collected at the satellite clinics, transported to the main ART center and underwentin vitro fertilization or intracytoplasmic sperm injection. Surplus embryos were used for frozen/thawed embryo transfer. We also evaluated 17 cycles in 10 patients in the transport embryo group (TE group), where surplus embryos were transported to the main ART center and used for frozen/thawed embryo transfer; and 189 cycles in 134 patients in the center group (C group), where surplus embryos collected at the same time at the main ART center were used for frozen/thawed embryo transfer. Oocytes were transported from satellite clinics in HEPES buffered human tubal fluid (HTF) culture medium, and embryos in 30% synthetic serum substitute + HEPES buffered HTF, using a portable incubator we devised. Results  The proportions of undamaged embryos after freeze/ thawing were 47% for the C group, 46% for the TO group, and 46% for the TE group. The numbers of embryos transferred were 2.0 ± 0.7 for the C group, 2.0 ± 0.6 for the TO group, and 2.2 ± 0.4 for the TE group. The rate of embryo transfer was 63% for the C group, 68% for the TO group, and 76% for the TE group. Pregnancy rates per patient were 16% for the C group, 24% for the TO group, and 40% for the TE group. The embryo survival rates (number of embryos with ≥50% viable blastomeres/total number of embryos) were 55% for the C group, 60% for the TO group, and 54% for the TE group. No significant differences were seen between the C group and either the TO or TE groups in any of these parameters. Conclusions  Favorable results were achieved with the transport oocyte/embryo frozen/thawed embryo transfer method, and it is suitable for widespread clinical application.     

冷冻前胚胎因素对冻融胚胎移植结局的影响

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。     

Viability of frozen-thawed human embryos with one–two blastomeres lysis

OBJECTIVE: To assess the impact of one-two blastomeres lysis on the viability of thawed day 3 human embryos. METHODS: A retrospective analysis was performed on 248 frozen-thawed embryo replacement cycles in which all embryos were frozen at day 3 at the seven-eight cell stage with 相似文献