冻融胚胎卵裂球损伤对于移植完整胚胎临床结局的影响

目的 探讨分裂期胚胎经玻璃化冷冻法冷冻复苏后,不同胚胎卵裂球的存活状态与移植完整胚胎后临床结局的关系.方法 回顾性分析南京市鼓楼医院生殖医学科2010年5月至2011年12月冻融胚胎移植（FET）周期648例（共1 736枚分裂期胚胎）,根据复苏后胚胎的卵裂球完整与否分为2组：胚胎卵裂球均完整组508例,卵裂球部分损伤组140例,均选择完整胚胎进行移植.比较2组的临床妊娠率、胚胎种植率及抱婴回家率.结果 FET胚胎卵裂球部分损伤组复苏的胚胎数显著高于卵裂球完整组（P〈0.01）,在临床妊娠率、胚胎种植率和抱婴回家率的比较中,卵裂球完整组具有显著优势（P〈0.05）.结论 经玻璃化冷冻技术冻融的优质胚胎中,部分胚胎卵裂球损伤提示剩余完整胚胎的发育潜能低于复苏后均完整的胚胎.

The influence of blastomere damage of frozen-thawed embryos on clinical outcomes of complete embryo transplantation

Objective To investigate the relationship of survival status of blastomeres in frozen-thawed embryos after vitrifica- tion and clinical outcomes of fully intact embryos transferred. Methods A total of 648 frozen-thawed embryos transfer（FET） cycles （including 1 736 embryos at cleavage stage） obtained from patients treated with IVF/ICSI at Reproductive Medicine Center of Drum-Tower Hospital from May 2010 to December 2011 were respectively analyzed,and divided into two groups according to the integrality of blastomeres：508 FET cycles with fully intact blastomeres and 140 with partially damaged blastomeres,and embryos remain intact were transferred in both groups. The clinical pregnancy rate, implantation rate and birth rate of two groups were com- pared. Results The number of embryos recovery of FET cycles with partially damaged blastomeres was significantly higher than that of fully intact blastomeres（P〈0.01） ,in comparison of pregnancy rate,implantation rate and birth rate, the group with intact blastomeres had distinct advantage with statistic difference （P〈 0. 05）. Conclusion During the vitrification procure of frozen- thawed embryos with good quality,partially damaged blastomeres suggest that the development ability of remained intact embryos is lower than that of fully intact embryos.