冻融胚胎和冻融囊胚对移植周期和分娩结局影响的比较

背景：自从1983年人类首例冷冻胚胎移植取得成功以来，胚胎冷冻技术已成为人类辅助生殖技术中重要组成部分。对选择冻融胚胎还是选择冻融囊胚移植，各地都有不少争议。目的：比较解胚胎和囊胚经过低温保存解冻复苏后的分娩结局及新生儿状况。方法：比较冻融胚胎移植周期1 273例和冷冻囊胚移植周期471例两组妊娠率、流产率、异位妊娠率、早产率、平均早产孕周、足月产率、平均足月产孕周、新生儿男女性别比例、出生体质量、出生缺陷等指标。结果与结论：冻融囊胚解冻周期478例，移植周期471例(其中7例无囊胚移植取消),妊娠236例，分娩201例，分娩胎数251胎，男孩140个，女孩111个。冻融第3天胚胎解冻周期1 280例，移植周期1 273例(其中7例无胚胎移植取消)，妊娠415例，分娩343例，分娩胎数431胎，男孩225个，女孩206个。冻融囊胚的妊娠率显著高于冻融胚胎妊娠率。冻融胚胎和囊胚的流产率、异位妊娠率、早产率、平均早产孕周、足月产率、平均足月产孕周、新生儿男女性别比例、出生体质量等差异无显著性意义。冻融胚胎和冻融囊胚移植出生缺陷并未明显增加。结果表明冻融囊胚与冻融胚胎的分娩结局及新生儿状况差异无显著性意义，但冻融囊胚的妊娠结局优于冻融胚胎的妊娠结局。中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程全文链接：

Effects of frozen thawed embryos versus frozen thawed blastocysts on transfer period and delivery outcomes

BACKGROUND:Since the first frozen embryo transplantation succeeded in 1983, embryo cryotechnique has been an important component in human assisted reproductive techniques. It is controversial which embryos and blastocysts after cryopreservation is selected.OBJECTIVE:To compare the birth outcomes and neonatal status of frozen thawed embryos and blastocysts. METHODS:In frozen thawed embryo group (n=1 273) and frozen thawed blastocyst group (n=471), we compared pregnancy rate, abortion rate, ectopic pregnancy rate, premature delivery rate, average premature gestational weeks, term yield, average full-term gestational age, newborn sex, birth weight, birth defects and so on.RESULTS AND CONCLUSION:There were frozen thawed blastocyst thaw cycles in 478 cases, 471 cases of transplantation period (including 7 cases without blastocyst transfer were canceled), 236 cases of pregnancy, 201 cases of delivery. Delivery number was 251, including 140 boys and 111 girls. The third day embryo thawing cycle of freezing and thawing appeared in 1 280 cases, 1 273 cases of transplantation period (including 7 cases of no embryo transplantation were canceled), 415 cases of pregnancy, 343 cases of delivery. The delivery number was 431, including 225 boys and 206 girls. Rate of pregnancy was significantly higher in frozen thawed blastocysts compared with frozen thawed embryos. No significant differences were detected in rate of miscarriage, ectopic pregnancy rate, premature delivery rate, average premature gestational weeks, term yield, average full-termgestational age, newborn sex, and birth weight between frozen thawed embryos and blastocysts. There was no increase in birth defects between frozen thawed embryos and blastocysts. Results suggested that no significant difference was detected in birth outcomes and neonatal status of frozen thawed embryos and blastocysts. Nevertheless, pregnancy outcome is better in frozen thawed blastocysts than frozen thawed embryos.