辅助生殖助孕技术中胚胎冻存年限对冻胚复苏移植临床结局的影响
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摘要
目的探究辅助生殖助孕技术中胚胎冻存年限对冻胚复苏移植临床结局的影响。方法选取2016年1月至2016年10月我院进行辅助生殖助孕技术的411例冷冻胚胎作为研究对象,根据冷冻时间的不同分为三组,甲组(n=174)冻存时间低于12个月,乙组(n=136)冷冻时间为12～24个月,丙组(n=101枚)冻存时间大于24个月。并观察两组复苏的发育潜力和妊娠结局。结果三组在复苏后的发育潜力上进行比较,甲组优质胚胎率、胚胎存活率、胚胎完整率、胚胎发育率、囊胚形成率以及优囊率上分别为80.46%、93.1%、51.72%、82.76%、55.17%、47.13%,而乙组分别为72.06%、90.44%、58.09%、76.47%、54.41%、36.76%,丙组在各项指标分别为73.27%、92.08%、52.48%、78.22%、53.47%、46.53%,三组在各项指标上均无显著差异(P>0.05)。三组在临床结局进行比较,甲组妊娠率、流产率分别为53.91%、10.94%,乙组妊娠率、流产率分别为53.85%、10.26%,而丙组妊娠率、流产率分别为53.73%、10.45%,三组在妊娠和流产上均无显著差异(P>0.05)。结论虽然本研究中未见不同冻存时间对胚胎生存能力的影响,但是基于样本选取的局限性和出于可能影响保存的因素考虑,建议如无必要,尽量选择冻存时间较短的胚胎。
Objective:To investigate the effect of embryonic cryopreservation time on the clinical outcome of frozen embryo resuscitation transplantation in assisted reproductive assisted pregnancy. Methods:A total of 411 frozen embryos from our hospital for assisted reproductive assisted pregnancy from January 2016 to October 2016 were selected as subjects. They were divided into three groups according to the freezing time. Group A(n=174)had low freezing time. In 12 months,group B(n=136)had a freezing time of 12 to 24 months,and group C(n=101 pieces)had a freezing time of more than 24 months. The developmental potential and pregnancy outcome of the two groups were observed. Results:The developmental potential of the three groups was compared after resuscitation. The quality of embryos,embryo survival rate,embryo integrity rate,embryo development rate,blastocyst formation rate and superior sac rate of group A were 80.46%,93.1%,and 51.72,respectively. %,82.76%,55.17%,and 47.13%,while Group B was 72.06%,90.44%,58.09%,76.47%,54.41%,and 36.76%,respectively. The indicators in Group C were 73.27%,92.08%,and 52.48%,respectively. 78.22%,53.47%,and 46.53%. There was no significant difference in the three groups among the three groups(P>0.05). The three groups were compared in clinical outcomes. The pregnancy rate and abortion rate of group A were 53.91% and 10.94%,respectively. The pregnancy rate and abortion rate of group B were 53.85% and 10.26%,respectively,while the pregnancy rate and abortion rate of group C were 53.73%. There was no significant difference in pregnancy and abortion between the three groups(10.05%)(P>0.05). Conclusion:Although there is no effect of different cryopreservation time on embryo viability in this study,based on the limitations of sample selection and factors that may affect preservation,it is recommended to select embryos with shorter freezing time if necessary.
Objective:To investigate the effect of embryonic cryopreservation time on the clinical outcome of frozen embryo resuscitation transplantation in assisted reproductive assisted pregnancy. Methods:A total of 411 frozen embryos from our hospital for assisted reproductive assisted pregnancy from January 2016 to October 2016 were selected as subjects. They were divided into three groups according to the freezing time. Group A(n=174)had low freezing time. In 12 months,group B(n=136)had a freezing time of 12 to 24 months,and group C(n=101 pieces)had a freezing time of more than 24 months. The developmental potential and pregnancy outcome of the two groups were observed. Results:The developmental potential of the three groups was compared after resuscitation. The quality of embryos,embryo survival rate,embryo integrity rate,embryo development rate,blastocyst formation rate and superior sac rate of group A were 80.46%,93.1%,and 51.72,respectively. %,82.76%,55.17%,and 47.13%,while Group B was 72.06%,90.44%,58.09%,76.47%,54.41%,and 36.76%,respectively. The indicators in Group C were 73.27%,92.08%,and 52.48%,respectively. 78.22%,53.47%,and 46.53%. There was no significant difference in the three groups among the three groups(P>0.05). The three groups were compared in clinical outcomes. The pregnancy rate and abortion rate of group A were 53.91% and 10.94%,respectively. The pregnancy rate and abortion rate of group B were 53.85% and 10.26%,respectively,while the pregnancy rate and abortion rate of group C were 53.73%. There was no significant difference in pregnancy and abortion between the three groups(10.05%)(P>0.05). Conclusion:Although there is no effect of different cryopreservation time on embryo viability in this study,based on the limitations of sample selection and factors that may affect preservation,it is recommended to select embryos with shorter freezing time if necessary.
引文
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[14] Sung L Y,Chang C C,Amano T,et al. Efficient derivation of embryonic stem cells from nuclear transfer and parthenogenetic embryos derived from cryopreserved oocytes.[J]. Cellular Reprogramming,2015,12(2):203.
[15]王彩玲,张华智,王利,等.影响哺乳动物卵母细胞玻璃化冷冻保存效果的因素[J].基因组学与应用生物学,2015,34(4):000849-854.
[2]Luke B,Brown M B,Spector L G. Validation of infertility treatment and assisted reproductive technology use on the birth certificate ineight states[J]. American Journal of Obstetrics&Gynecology,2016,215(1):126-127.
[3]纪冰,马学工.宫腔内人工授精及后续体外受精-胚胎移植助孕的临床疗效分析[J].中国妇幼保健,2016,31(4):786-788.
[4]李楠,牟联俊,李忻琳,等.不同胚胎冷冻保存时间和方法对FET周期临床结局的影响[J].实用医学杂志,2017,33(10):1638-1641.
[5]Schwarze J E,Crosby J A,Zegers-Hochschild F. Effect of embryo freezing on perinatal outcome after assisted reproduction techniques:lessons from the Latin American Registry of Assisted Reproduction[J]. Reproductive Biomedicine Online,2015,31(1):39-43.
[6]郐艳荣,王晟,张凯,等. 1008个冷冻胚胎移植周期妊娠结局影响因素的分析[J].中国性科学,2016,25(3):113-117.
[7]Casper R F,Yanushpolsky E H. Optimal endometrial preparation for frozen embryo transfer cycles:window of implantation and progesterone support[J]. Fertility&Sterility,2016,105(4):867-872.
[8]Jing S,Luo K,He H,et al. Obstetric and neonatal outcomes in blastocyst-stage biopsy with frozen embryo transfer and cleavagestage biopsy with fresh embryo transfer after preimplantation genetic diagnosis/screening[J]. Fertility&Sterility,2016,106(1):105-112.e4.
[9]乜照燕,吴海峰,张娜,等.卵母细胞培养时间对单精子胞浆内注射胚胎质量及妊娠结局影响[J].中国男科学杂志,2015,29(1):28-31.
[10] Yin H,Hong J,He R,et al. The effects of blastocyst morphological score and blastocoele re-expansion speed after warming on pregnancy outcomes[J]. Clinical&Experimental Reproductive Medicine,2016,43(1):31-37.
[11]张军,余兰,王树玉,等.胚胎冷冻保存时间对冻融胚胎移植临床妊娠率的影响[J].中国优生与遗传杂志,2016(9):113-114.
[12] Molina I,Mari M,Martínez J V,et al. Bacterial and fungal contamination risks in human oocyte and embryo cryopreservation:open versus closed vitrification systems.[J]. Fertility&Sterility,2016,106(1):127-132.
[13]郭立燕,翟敏,王莎莎,等.胚胎停育影响因素的Meta分析[J].中国儿童保健杂志,2016,24(2):166-169.
[14] Sung L Y,Chang C C,Amano T,et al. Efficient derivation of embryonic stem cells from nuclear transfer and parthenogenetic embryos derived from cryopreserved oocytes.[J]. Cellular Reprogramming,2015,12(2):203.
[15]王彩玲,张华智,王利,等.影响哺乳动物卵母细胞玻璃化冷冻保存效果的因素[J].基因组学与应用生物学,2015,34(4):000849-854.