【摘要】 目的:冻胚移植与取卵周期新鲜胚胎移植的妊娠率相比仍偏低。该研究是为了探索一种可以提高冻胚移植妊娠率的方法。方法:①将解冻后无移植价值的30个胚胎(A组)及取卵周期移植后废弃的30个胚胎(B组)作1%Pronase酶消化透明带的实验,记录残留透明带的厚度并作统计学处理。②在131个冷冻胚胎移植周期中,全部解冻后胚胎立即行激光削薄透明带辅助孵化,并随机分为两组:C组,培养48h移植;D组,培养2h后即移植。记录移植胚胎的评分,随访两组妊娠结局,比较两组间妊娠率、种植率、早期妊娠流产率。结果:①A组和B组透明带厚度平均(19.07±0.84)μm和(19.03±0.75)μm,P>0.05。经过Pronase消化后,A组残留透明带的厚度大于B组,分别为(13.01±0.88)μm和(8.7±0.73)μm(P<0.05),差异有显著性。②C组68周期中行早期桑椹或囊胚移植60周期,妊娠23例,D组63周期中行分裂期胚胎移植60周期,妊娠14例,C组和D组妊娠率分别为33.82%和22.22%,种植率分别为28.3%和15.5%,差异有显著性,P<0.05。C组内无早期桑椹或囊胚移植的共6个周期,占11.76%,高于D组的无胚胎移植率(4.76%,2个周期),P<0.05。两组早期妊娠流产率分别为13.04%(3/23)和14.28%(2/14),无显著性差异,P>0.05。结论:冻融胚胎的透明带与新鲜胚胎相比,其硬度增加,因此给予冻胚的透明带行激光辅助孵化是必要的。囊胚培养联合激光辅助孵化增加了冻胚移植的妊娠率和种植率,这是提高冻胚移植成功率的有效方法。更多还原

【Abstract】 Objective:To explore a method to increase the pregnancy rate of frozen-thawed embryo transfer (FET).Methods:30 unvalued embryos after thawing (group A) and 30 disused embryos after transfer (group B) were put into 1% Pronase medium to digest the pellucid zone,the thickness of residual pellucid zone was recorded and analysed.Among 131 cycles of embryo transfer,embryo after thaw received assisted hatching on the basis of pellucid zone,then were divided into group C (cultured 48 hours before transfer) and group D (cultured 2 hours before transfer).The score of embryo was recorded,pregnancy outcomes were followed up,and the rates of pregnancy,implantation and early abortion were compared between the two groups.Results:There was no significant difference in thickness of pellucid zone between group A [(19.07±0.84)μm] and group B [(19.03±0.75)μm] (P>0.05).After digestion,the thickness of residual pellucid zone in group A was [(13.01±0.88)μm],which was thicker than that in group B [(8.7±0.73)μm] (P<0.05).In group C,60 cycles of transfer were performed at blastocyst stage,and 23 women (33.82%) got pregnancy;in group D,60 cycles of transfer were performed at mitotic phase,and 14 women (22.22%) got pregnancy,the rates of implantation in group C and group D were 28.3% and 15.5%,respectively,there was significant difference (P<0.05).The proportion of cancelled cycles in group C (6 cycles,11.76%) was significantly higher than that in group D (2 cycles,4.76%) (P<0.05).There was no significant difference in rate of early abortion between group C (13.04%,3/23) and group D (14.28%,2/14).Conclusion:Compared to fresh pellucid zone,the pellucid zone of frozen-thawed embryo is harder,thus assisted hatching of frozen-thawed embryo is necessary,laser assisted hatching and blastocyst culture can increase the rates of pregnancy and implantation,which is a effective method to improve the success rate of frozen-thawed embryo transfer.更多还原