摘要
目的探讨控制性卵巢刺激(COS)全胚冷冻周期第3天(D3)胚胎冷冻复苏后隔夜培养移植过程中空泡出现时机以及空泡卵裂球比例对妊娠结局的影响。方法回顾性分析重庆市遗传与生殖研究所2017年1月至2019年12月期间行冻融胚胎移植(FET)患者的临床资料,共3528个周期纳入研究。根据空泡出现的时机分为3组:解冻时空泡组312个周期,隔夜培养后空泡组(培养后空泡组)601个周期;无空泡组2615个周期;根据空泡卵裂球数目占胚胎卵裂球总数的比例分为2组:<30%组679个周期;≥30%组234个周期。比较各组之间的种植率、临床妊娠率和流产率。结果解冻时空泡组种植率(41.38%)显著低于培养后空泡组(45.63%)和无空泡组(45.54%)(P<0.05);解冻时空泡组FET日空泡卵裂球胚胎比例显著高于培养后空泡组[(30.71±21.99)%vs.(24.51±18.31)%,P<0.05];3组间流产率比较无显著性差异(P>0.05)。不同空泡卵裂球胚胎比例组间比较结果显示,≥30%组的种植率和临床妊娠率(分别为39.78%和54.70%)均显著低于<30%组(分别为45.69%和65.24%)和无空泡组(分别为45.54%和64.89%)(P<0.05);<30%组与无空泡组相比,各指标无显著性差异(P>0.05)。结论解冻时胚胎中存在的空泡经隔夜培养后空泡卵裂球比例会显著增多,且当空泡卵裂球比例≥30%时会显著影响胚胎的种植潜能。
Objective:To explore the effects of the timing of vacuoles and the proportion of vacuolar blastomeres of Day 3 embryos on pregnancy outcomes during overnight culture transfer in whole embryo freezing cycles with controlled embryonic ovulation(COS).Methods:In this retrospective study,the clinical data of patients(3528 cycles)who underwent frozen-thawed embryo transfer(FET)in Chongqing Reproductive and Genetics Institute from 2017 to 2019 were collected and analyzed.The cycles were divided into three groups according to the timing of vacuole appearance:vacuole occurrence during thawing group(n=312),vacuole occurrence during overnight culture group(n=601)and non-vacuole group(n=2615 cycles).These cycles with vacuole were divided into two groups according to the proportion of blastomeres with vacuoles,<30%group(n=679)and≥30%group(n=234).The implantation rate,clinical pregnancy rate and miscarriage rate were compared among the groups.Results:The implantation rate(41.38%)in vacuole occurrence during thawing group was significantly lower than that in vacuole occurrence during overnight culture group(45.63%)and non-vacuole group(45.54%)(P<0.05).The proportion of blastomeres with vacuoles on FET day in vacuole occurrence during thawing time group was significantly higher than that in vacuole occurrence during overnight culture group[(30.71±21.99)%vs.(24.51±18.31)%](P<0.05).There was no significant difference in miscarriage rate among the three groups(P>0.05).The implantation rate(39.78%)and clinical pregnancy rate(54.70%)in≥30%group were significantly lower than those in<30%group(45.69%and 65.24%,respectively)and non-vacuole group(45.54%and 64.89%,respectively)(P<0.05).There was no significant difference in the various indicators between<30%group and non-vacuole group(P>0.05).Conclusions:The vacuoles occurrence in the embryos during thawing will significantly increase after overnight culture.When the proportion of blastocysts with vacuoles is≥30%,it will significantly affect the embryo implantation potential.
作者
朱家红
武丽红
熊顺
高洋
黄国宁
ZHU Jia-hong;WU Li-hong;XIONG Shun;GAO Yang;HUANG Guo-ning(Chongqing Key Laboratory of Human Embryo Engineering,Chongqing Reproductive & Genetics Institute,Chongqing Health Center for Women & Children,Chongqing 400013)
出处
《生殖医学杂志》
CAS
2020年第9期1132-1136,共5页
Journal of Reproductive Medicine
基金
重庆市科卫联合医学科研项目(2017MSXM111)
中华医学会临床医学科研专项基金(17020440713)。
关键词
空泡
解冻复苏
临床妊娠率
种植率
流产率
Vacuoles
Frozen-thawed
Clinical pregnancy rate
Implantation rate
Miscarriage rate
