玻璃化冷冻法在人桑葚胚胎和卵裂期胚胎冻融周期中的临床研究

目的探讨玻璃化冷冻法对人桑葚胚和卵裂期胚胎解冻后的妊娠结局。方法回顾性分析河北医科大学第二医院生殖中心行冻融胚胎移植患者的解冻及妊娠情况,并根据冷冻方法和胚龄分为3组。A组为前期采用慢速程序法冷冻卵裂期胚胎的冻融移植周期,共215周期;B组为前期采用玻璃化法冷冻卵裂期胚胎的冻融移植周期,共208周期;C组为前期采用玻璃化法冷冻桑葚期胚胎的冻融移植周期,共159周期。比较A组和B组解冻后的胚胎存活率、存活胚胎的完整率、临床妊娠率、胚胎种植率和流产率;比较B组和C组解冻后的胚胎存活率、存活胚胎的完整率、临床妊娠率、胚胎种植率和流产率。结果 A组和B组比较,胚胎存活率和存活胚的完整率差异有统计学意义(P<0.01),胚胎种植率、临床妊娠率、流产率差异有统计学意义(P<0.05),临床妊娠率差异无统计学意义(P>0.05),而胚胎种植率、流产率差异有统计学意义(P<0.05)。B组和C组比较,存活胚完整率差异有统计学意义(P<0.01),胚胎种植率差异有统计学意义(P<0.05),胚胎存活率和临床妊娠率C组高于组B,但差异无统计学意义(P>0.05)。结论玻璃化冷冻法在冷冻人卵裂期胚胎由于具有较高的胚胎存活率和存活胚完整率而优于慢速程序化冷冻法。而桑葚期胚胎的玻璃化冷冻法在存活胚的完整率和胚胎种植率上优于卵裂期胚胎,可能是玻璃化法冷冻保存胚胎的较好时期。

Application of vitrification cryopreservation in human morula embryos and cleavaged embryos during frozen-thawed cycle

Objective To investigate the outcome after thawing human morula and cleaved embryos by vitrification cryopreservation.Methods A retrospective study was carried out in the center of Reproductive Medicine of the Second Hospital of Hebei Medical University from January 2010 to December 2011 for the information of frozen-thawed and pregnancy in the patients who received frozen-thawed embryo transfer.According to the age of embryo and cryopreservation methods,the cycles were divided into 3 groups,including 215 cycles of freezing slowly the embryos at cleavage stage(Group A),208 cycles of frozen-thawed embryo transfer by vitrification cryopreservation(Group B) and 159 cycles of frozen-thawed embryo transfer by vitrification cryopreservation to freeze embryos at cleavage stage at early period(Group C).The clinical outcomes and laboratory parameters including embryo survival rates,integrity rates of survival embryos,clinical pregnancy rates,embryo implantation rates and abortion rates were compared between group A and group B and between group B and group C.Results There were significant differences in embryo survival rates and integrity rates of survival embryos between group A and group B(P<0.01),however,there were no significant differences in embryo implantation rates,clinical pregnancy rates and abortion rates between the two groups,(P>0.05).There was a significant difference in the integrity rate of survival embryos between group B and group C(P<0.01),and in embryo implantation rates(P<0.05).The embryo survival rates and clinical pregnancy rates in group C were higher than those of group B,but there were no significant differences between the two groups(P>0.05).Conclusion The vitrification cryopreservation is superior to slow programmed cryopreservation in freezing embryos at cleavage stage,for the former has higher embryo survival rates and integrity rates of survival embryos.However the integrity rates of survival embryos and embryo implantation rates in morula embryos treated by vitrification cryopreservation are superior to those of embryos at cleavage stage,which may be the better duration for keeping embryos by vitrification cryopreservation.