玻璃化冷冻法冻融经植入前遗传学诊断后囊胚的应用初探

目的:探讨玻璃化冷冻技术冻融经卵裂球活检后囊胚的可行性。方法:将活检后剩余的可移植囊胚用玻璃化冷冻保存,并在冷冻前人工皱缩囊胚腔,在需要移植时予以解冻囊胚进行移植。结果:24例共进行24个活检周期,活检了159个胚胎,活检后胚胎囊胚形成率60.38%(96/159)。有17个周期共移植26枚新鲜可用囊胚,成功种植13个(50.0%),11例获得临床妊娠(64.71%),7个周期因无可移植胚胎或卵巢过度刺激等因素而取消移植。10例患者(10个周期)有30个可移植囊胚进行了玻璃化冷冻保存,其中6例患者因未成功生育要求解冻其囊胚进行移植。共解冻8枚囊胚,全部存活并移植,5例获单胎妊娠;2例已分娩正常婴儿,3例继续妊娠中。结论:玻璃化冷冻技术结合人工皱缩囊胚腔能冷冻保存经卵裂球活检后的囊胚。

A Preliminary Study on the Application of Vitrification of Biospied Blastocyst after Preimplantation Genetic Diagnosis

Objective： To investigate the feasibility of vitrification of blastocysts following blastomere biopsy.Methods： Among patients undergoing pre-implantation genetic diagnosis（PGD）,artificial shrinkage of the blastocoelic cavity and subsequent vitrification of applicable surplus blastocysts after day-3 blastomere biopsy were performed.According to patient’s requirements,thawed blastocysts were transferred into patients due to pregnancy failure after fresh embryo transfer,ectopic pregnancy or ovarian hyperstimulation.Results： Twenty-four PGD cycles were carried out.According to the results of genetic diagnosis and the development of blastocysts,embryo transfer was canceled due to absence of applicable embryos or ovarian hyperstimulation in 7 cycles.In the remaining 17 cycles,26 blastocysts were transferred in which 13 blastocysts were successfully implanted（50.0%）.Clinical pregnancies were observed in 11 patients（64.71%）.Following transfer,30 applicable blastocysts in 10 cycles were cryopreserved.Six patients were transfered with the thawed blastocysts.All 8 thawed embryos survived and were transferred,and singleton pregnancy occurred in 5 patients.Two women delivered healthy infants and the other 3 pregnancies are ongoing.Conclusion： Vitrification with artificial shrinkage is feasible for preserving blastocysts following blastomere biopsy.