卵母细胞玻璃化冷冻与ICSI妊娠结局的相关性研究

目的探讨卵母细胞玻璃化冷冻与ICSI妊娠结局的相关性。方法回顾性分析2018~2019年在本生殖中心因取卵日取精失败或卵母细胞捐赠行卵母细胞玻璃化冷冻,复苏后行ICSI治疗的14例患者(冷冻组)的临床资料,与新鲜卵母细胞ICSI治疗的88例患者(新鲜组)的临床结局和妊娠产科结局进行比较分析。结果共99枚卵母细胞行玻璃化冷冻复苏,复苏存活率为84.85%。冷冻组与新鲜组的ICSI受精率(72.62%vs.79.32%)、卵裂率(98.21%vs.98.57%)、临床妊娠率(60.00%vs.65.63%)、胚胎种植率(31.58%vs.43.75%)比较均无统计学差异(P>0.05)。冷冻组的优质胚胎率显著低于新鲜组(43.64%vs.59.96%,P<0.05)。两组间的流产率、早产率、低出生体重率、巨大儿率、新生儿出生缺陷率和围产儿死亡率等妊娠产科结局比较均无统计学差异(P>0.05)。结论卵母细胞玻璃化冷冻复苏后行ICSI治疗,优质胚胎率较新鲜卵母细胞ICSI降低,但移植优质胚胎后可获得与新鲜卵母细胞相似的临床结局,可应用于辅助生殖临床治疗。

Study on correlation between vitrification of oocytes and pregnancy outcome of ICSI

Objective:To investigate the correlation between vitrification of oocytes and pregnancy outcomes of ICSI.Methods:The clinical data of 14 patients who underwent ICSI after oocyte vitrification-thawed due to failure of sperm retrieval on the oocyte retrieval day or oocyte donation were retrospectively analyzed and compared with the clinical and pregnancy outcomes of 88 patients treated with fresh oocytes ICSI.Results:Ninety nine oocytes underwent vitrification-thawed,and the oocyte survival rate was 84.85%.There was no significant difference in ICSI fertilization rate(72.62%vs.79.32%),cleavage rate(98.21%vs.98.57%),clinical pregnancy rate(60.00%vs.65.63%),and implantation rate(31.58%vs.43.75%)between frozen-thawed group and fresh oocyte group(P>0.05).The rate of high-quality embryo in frozen-thawed group was significantly lower than that of fresh group(43.64%vs.59.96%,P<0.05).There was no significant difference in abortion rate,premature birth rate,low birth weight rate,macrosomia rate,birth defect of newborn rate and perinatal mortality rate between the two groups(P>0.05).Conclusions:ICSI treatment after vitrification-thawed of oocytes reduces the rate of high-quality embryos compared with fresh oocytes.However,the clinical outcomes of high-quality embryo transfer is similar to those of fresh oocytes transfer,which can be used in assisted reproductive therapy.