激光辅助孵化对冻融双胚胎移植后胚胎存活及双胎子代发育的影响

目的 通过分析来自激光辅助孵化(LAH)的冻融D3卵裂期双胚胎移植后胚胎存活情况、双胎新生儿发育及周岁婴幼儿发育情况,评估LAH技术对胚胎存活及新生儿与婴幼儿发育的影响。方法 选取2017年1月至2019年12月浙江省人民医院收治的843例双胚胎移植不孕症患者,根据移植前是否需激光辅助孵化(LAH)分为LAH组381例和非LAH组462例。LAH组移植前采用LAH处理,非LAH组移植前无LAH处理步骤。比较两组妊娠结局,并选择双胚胎存活的156例患者(其中LAH组65例,非LAH组91例)双胎出生后代的生长发育指标,包括出生孕龄、体重、畸形情况及周岁时身高、体重等,分析LAH对胚胎及婴幼儿发育的长期影响。结果LAH组与非LAH组胚胎存活率比较,差异无统计学意义(P0.05);LAH组与非LAH组A胎出生体重、B胎出生体重、先天性畸形的比例比较,差异均无统计学意义(P0.05);两组双胎婴幼儿1周岁时均无身高、体重、认知、出牙、运动能力的异常,差异无统计学意义(P0.05)。结论 LAH的应用对冻融双胚胎移植后的胚胎存活率、双胎子代新生儿发育及1周岁婴幼儿发育影响均无明显影响,对于双胎新生儿畸形率的影响尚需更多病例的研究。

Effects of laser-assisted hatching on embryo survival and twin progeny development after freeze-thaw double embryo transfer

Objective To evaluate the effects of LAH on embryo survival and neonatal and infant development by analyzing the embryo survival,twin neonatal development and 1-year-old infant development after double embryo transfer at?D3?cleavage of freeze-thaw from laser-assisted incubation (LAH).Methods A total of 843 infertility patients with double embryo transfer who were admitted to Zhejiang Provincial People''s Hospital from January 2017 to December 2019 were selected and divided into the LAH group(n=381) and the non-LAH group(n=462) according to the need for laser-assisted incubation (LAH) before transplantation.LAH treatment was used before transplantation in the LAH group,while no LAH treatment was used before transplantation in the non-LAH group.The pregnancy outcomes of the two groups were compared,and 156 patients with twin embryo survival (including 65 patients in the LAH group and 91 patients in the non-LAH group) were selected for the twin progeny growth and development indicators,including the gestational age at birth,weight,malformation,height and weight at the first year of life,etc.,to analyze the long-term effects of LAH on the development of embryos and infants.Results No significant difference was observed in the embryo survival rate between the LAH group and the non-LAH group(P>0.05).No significant differences were observed in the birth weight of A,birth weight of B and the proportion of congenital malformation between the LAH group and the non-LAH group (P>0.05).No abnormalities were observed in height,weight,cognition,teething and motor ability of twins in the two groups at the age of 1,and the differences were not statistically significant (P>0.05).Conclusion The application of LAH has no significant influence on the embryo survival rate,the development of twin babies and the development of infants at the age of 1 after the freeze-thaw double embryo transfer.The influence of LAH on the deformities rate of twin babies is still needed to be studied in more cases.