冻融囊胚移植后临床结局分析

目的比较第5天（D5）和第6天（D6）囊胚期玻璃化冻融胚胎移植的临床结局，分析自然周期和替代周期对囊胚期冻融胚胎移植的影响。方法将移植后剩余胚胎进行囊胚培养至D5或D6后行玻璃化冻融，比较囊胚复苏后的临床妊娠率、自然流产率及种植率等指标。结果D5组解冻154个囊胚，153个存活，复苏存活率99．4％；D6组解冻100个囊胚，99个存活，复苏存活率99％，两组复苏存活率无显著性差异（P〉0．05）。总临床妊娠率D5组（54．4％）显著高于D6组（20％）（P〈0．01）。自然流产率D5组为6．1％，而D6组则为9．1％，两组相比，无统计学差异（P〉0．05）。种植率D5组（41。2％），显著高于D6组（11．1％）（P〈0．01）。替代周期组（HRT）和自然周期组（NC）相比，NC组的临床妊娠率及种植率均高于HRT组，但均无显著性差异（P〉0．05）。结论D5囊胚冷冻复苏后移植能获得较好的妊娠结局，内膜准备方法不同即替代周期和自然周期对临床结果并无影响。

Analysis of the clinical outcomes of human blastocyst cryopreservation

Objective： To compare the clinical outcome of vitrified-thawed human blastocysts at day 5 （D5） or day 6 （D6） in natural cycle or hormone replacement therapy cycle. Methods： In IVF-ET cycles, supernumerary embryos were cultured to D5 or D6, and the blastocysts were vitrified. The clinical pregnant rate, abortion rate and implantation rate were compared. Results： In D5 group, 154 blastocysts were thawed, and 153（99.4%）of them were survived. There were 49 women got clinically pregnant （54.4%）, but 3 （6.1%） of them suffered from miscarriage. In D6 group, 100 blastocysts were thawed, and 99（99%）of them were survived, 11 women （20%） got clinical pregnancy, 1 （9.1%） of them miscarried, the other 10 pregnancies were ongoing. The clinically pregnant rate and implantation rate in D5 group were both significantly higher than those of D6 group （P〈0.01）. In addition, there were no significant difference in the clinical pregnancy rate and implantation rate between natural cycles and hormone replacement therapy cycles （P〉0.05）. Conclusions： The vitrified-thawed blastocysts at D5 could get better outcomes, and different programs of endometrium preparation by natural cycles or hormone replacement therapy had no different effect on clinical outcomes.