国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2014, Vol. 33 ›› Issue (4): 274-276.

• 论著 • 上一篇    下一篇

胚胎卵裂球数及取卵后2天和3天冷冻对冻融胚胎移植临床结局的影响

焦杰华，朱桂杰，谭丽   

  1. 467000 河南省平顶山市第五人民医院（焦杰华）；郑州大学第二附属医院生殖医学部（朱桂杰，谭丽）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-07-15 发布日期:2014-07-15
  • 通讯作者: 谭丽

Impact of Embryo Blastomere Number and D2 or D3 Cryopreservation after in Vitro Fertilization on the Clinical Outcomes of the Frozen-thawed Embryo Transfer

JIAO Jie-hua，ZHU Gui-jie，TAN Li   

  1. The Pingdingshan Fifth People′s Hospital，Pingdingshan 467000，Henan Province，China（JIAO Jie-hua）；Reproductive Medical Center，the Second Affiliated Hospital of Zhengzhou University，Zhengzhou 450014，China（ZHU Gui-jie，TAN Li）
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-07-15 Online:2014-07-15
  • Contact: TAN Li

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摘要： 目的：探讨胚胎卵裂球数及取卵后2天（D2）和3天（D3）冷冻对胚胎的复苏效果以及冻融胚胎移植（FET）临床结局的影响。方法：回顾性分析2010年1月—2012年5月行FET的417个周期的临床资料，分别按胚胎冷冻的时间（D2/D3）、卵裂球数、移植优质胚胎数进行分组，比较各组的胚胎复苏效果及临床结局。结果：D2≥4-细胞组的胚胎复苏率和卵裂球全存活率显著高于D2＜4-细胞组（89.35% vs. 79.11%，42.01% vs. 30.22%，P＜0.05）；D3≥6-细胞组的胚胎复苏率和卵裂球全存活率显著高于D3＜6-细胞组（86.52% vs. 72.43%，41.13% vs. 31.07%，P＜0.01）。D2组冷冻胚胎复苏后的优质胚胎率（56.84%）高于D3组（48.82%），但D3组FET临床妊娠率（38.52%）高于D2组（27.61%），差异均有统计学意义（P＜0.05），2组间胚胎复苏率和流产率差异无统计学意义（83.50% vs. 79.44%，10.81% vs. 10.09%，P＞0.05）。随着移植优质胚胎数的增加，临床妊娠率和多胎率增加，差异有统计学意义（P＜0.05）。结论：D2≥4-细胞和D3≥6-细胞的胚胎冻融效果较好，D3冷冻胚胎的FET临床结局优于D2冷冻胚胎。

关键词: 胚胎冷冻, 冻融胚胎移植, 复苏率, 妊娠率

Abstract: Objective: To explore the impact of embryo blastomere number at cryopreservation, and different cryopreservation time on day 2 （D2） or day 3 （D3） after in vitro fertilization，on the clinical outcomes of the frozen-thawed embryo transfer（FET）. Methods：This is a retrospective analysis on 417 FET cycles. The patients were respectively divided into different groups according to cryopreservation time after in vitro fertilization，embryo blastomere number and good-quality embryo number. The clinical outcomes of the embryo-transfer were compared. Results：The embryo survival rate and total blastomere survival rate in the group of the blastomere number exceeded 4-cells on D2 after frozen-thawed were significantly higher than those in the group of the blastomere number less than 4-cells（89.35% vs. 79.11%，42.01% vs. 30.22% respectively，P＜0.05）. Compared with the group of blastomere less than 6-cells on D3，the group of blastomere exceeded 6-cells on D3 had higher embryo survival rate and total blastomere survival rate（86.52% vs. 72.43%，41.13% vs. 31.07%，P＜0.01）. The good-quality embryo rate on D2（56.84%） was significantly higher than that on D3 （48.82%），while the clinical pregnancy rate on D3（38.52%） was significantly higher than that of D2 （27.61%）. There was no significant difference in the embryo survival rate and abortion rate between D2 and D3 （83.50% vs. 79.44%，10.81% vs. 10.09%，P＞0.05） after frozen-thawed embryo-transfer. More good-quality embryos were transferred，higher the clinical pregnancy rate and multiple pregnancy rate obtained（P＜0.05）. Conclusions：Cryopreservation of more than 4 blastomeres on D2 and more than 6 blastomeres on D3 could get better frozen-thawed effect. The clinical outcomes of D3 cryopreservation embryo after FET were superior to D2 embryo.

Key words: Embryo cryopreservation, Frozen-thawed embryo transfer, Survival rate, Pregnancy rate