冻融胚胎复苏状态对移植周期临床结果的影响

目的　观察冻融胚胎复苏状态对移植周期临床结果的影响。　方法　 94对夫妇共进行冻融胚胎移植 (F ET) 99周期。其中自然周期 67个 ,激素替代治疗 3 2周期。冻融 2d或 3d胚胎采用慢速冷冻法和快速解冻法 ,根据卵裂球存活程度分为 3组 :A组为全部移植 1 0 0 %卵裂球存活胚胎 ;B组为全部移植部分卵裂球受损胚胎和C组为混合移植。　结果　 99个周期共融解胚胎 3 3 0个、移植 2 87个 ,融胎存活率 87% ,临床妊娠率 2 3 % ( 2 3 / 99) ,胚胎种植率 1 0 % ( 3 0 / 2 87)。A组临床妊娠率 3 1 % ( 6/ 1 4 )、种植率1 8% ( 1 0 / 3 8) ,B组分别为 6% ( 1 / 1 6)及 2 % ( 1 / 41 ) ,C组分别为 2 3 % ( 1 6/ 69)及 9% ( 1 9/2 0 8) ,A ,B两组比较差异有显著意义 (P <0 .0 5)。进一步分析F ET胚胎中含 4或 8细胞卵裂球完好胚胎数 0 2 ,≥ 3的胚胎种植率 ,分别为 4.5%、1 0 %、1 2 .5%及 43 % ;4组间差别有显著性 (P <0 .0 5)。　结论　移植冻融胚胎卵裂球复苏状态与临床妊娠率密切相关

Relationship between the survival situation of thawed embryos and clinical outcome in frozen-thawed embryo transfer cycles

Objective: To investigate the influence of the survival situation of thawed embryos on clinical outcome in frozen -thawed embryo transfer (F-ET)cycles. Methods: 99 F-ET cycles were included in this study. Embryos were cryopreserved on day 2 or on day 3 with 1,2 propanediol-sucrose by slow-freezing protocol and were thawed using rapid-thawed protocol. Survival was defined as at least 50% of the blastomeres being intact. Frozen-thawed embryos were transferred in natural cycles(67) or artificial cycles (HRT,32). All F-ET cycles were divided into three groups: group A (14 transfer cycles only with fully intact embryos); group B (16 transfer cycles only with partially damaged embryos) and group C(69 cycles mixed transfer of fully intact embryos together with partially damaged ones). Results: We retrospectively analysed 99 cycles with cryopreserved embryos. A total of 330 frozen -thawed embryos and survival 287 embryos (survival rate 87%) were transferred in 99 transferred procedures. Overall, clinical pregnancy rate was 23% (23/99); embryo implantation rate was 10% (30/287). The percentage of gestational sacs with fetal heartbeat and pregnancy rate of group A was higher than those of group B (P<0.05). There were significant differences of implantation rates (4.5%, 10%, 12.5%, 43% respectively,P<0.05) when 0,1,2 and ≥3 fully intact 4-cell or 8-cell embryos after thawing were transferred. Conclusion: Although clinical pregnancies have been obtained after transfer of partially damaged embryos, their implantation rate was significantly lower than that after transfer of fully intact embryos. The survival situation of thawed embryos and clinical outcome in F-ET cycles were showed distinctly correlation. The aim of a cryopreservation program must be to obtain fully intact embryos after thawing.