【摘要】 目的分析卵裂期胚胎冻融后的发育速度与其临床结局的关系,探讨胚胎解冻后的发育速度能否成为评估其植入潜能的参数。方法回顾性分析卵裂期胚胎解冻后继续培养情况,比较1 426个移植时无囊胚形成的周期(无囊胚形成组)及113个移植时已有囊胚形成的周期(囊胚形成组,根据囊胚个数分为1个囊胚组和1个以上囊胚组)的种植率及临床妊娠率。结果无囊胚形成组与囊胚形成组的种植率(26.49%vs.34.96%)及临床妊娠率(45.09%vs.59.29%)均有统计学差异(P<0.05),且1个以上囊胚组的种植率(48.81%)、临床妊娠率(74.29%)均显著高于1个囊胚组(分别为28.57%、52.56%)及无囊胚形成组(分别为26.49%、45.09%)(P<0.05),囊胚形成组及其两个亚组的多胎率较无囊胚形成组有升高趋势,但无统计学差异(P>0.05);8-细胞胚胎组及融合胚胎组移植时形成囊胚的比例都显著高于8-细胞以下胚胎组(5.21%vs.11.50%vs.0.85%)(P<0.05);且8-细胞胚胎组与融合胚胎组形成囊胚的比例也有显著差异(P<0.05)。Logistic分析表明,移植个数及移植的囊胚数与临床妊娠显著相关(P<0.05)。结论卵裂期优质胚胎解冻后继续培养18~24h,部分胚胎已发育为囊胚,且这些胚胎的植入能力和发育潜能更好。对于解冻后培养有1个以上囊胚形成的患者,建议行选择性单胚胎移植。更多还原

【Abstract】 Objective:To analyze the relationship between the development speed of embryos at cleavage stage after frozen-thawed and clinical outcome,and explore whether the development speed of embryos can assess implantation potential.Methods:A total of 1 539frozen-thawed cycles were analyzed retrospectively.The cycles were divided into two groups by the morphology of the embryo:blastocyst formation group(113cycles)and nonblastocyst formation group(1 426cycles).The cycles of blastocyst formation group were subdivided into two groups:one blastocyst formation group and more than one blastocyst formation group.The pregnancy rate and implantation rate and the cultured result after thawing were compared among the groups.Results:The pregnancy rate(45.09% vs.59.29%)and implantation rate(26.49% vs.34.96%)were significantly different between the non-blastocyst formation group and blastocyst formation group.Thepregnancy rate(74.29% vs.52.56% vs.45.09%)and implantation rate(48.81% vs.28.57% vs.26.49%)of more than one blastocyst formation group were significantly higher than those of one blastocyst formation group and non-blastocyst formation group(P<0.05).The multiple pregnancy rate of the nonblastocyst formation group was lower than other groups,but it was not significant(P >0.05).The blastocyst formation rate of 8-cell embryos group(5.21%)or compacted embryos group(11.50%)was significantly higher than that of less than 8-cell embryos group(0.85%)(P<0.05).The result of logistic analysis showed that the number of embryos transferred and the number of blastocysts transferred were significantly associated with the clinical pregnancy rate(P<0.05).Conclusions:Some embryos at cleavage stage can develop to blastocyst after frozen-thawed and cultured for 18-24 hours.The implantation ability and development potential of the embryos which can develop to blastocyst are better.Single embryo transfer will be recommended for the patients who have more than one blastocyst formation after frozen-thawed.更多还原