【摘要】 目的探讨激光透明带打孔和激光透明带薄化辅助孵化方法在冻融胚胎移植中的应用效果。方法选取2011年10月~2013年10月于佛山市妇幼保健院行体外受精胚胎移植周期中剩余可利用冷冻保存胚胎的病例280例作为研究对象,采用数字随机法将其分为两组,140例行激光透明带打孔辅助孵化为对照组,140例行激光透明带薄化辅助孵化为观察组。比较两组患者冻融胚胎的移植情况和妊娠情况,分析不同年龄及胚胎评分患者的临床妊娠率。结果观察组复苏率(98.6%)、完整胚胎率(97.1%)、移植胚胎的形态学评分[(5.84±0.96)分]、移植胚胎数[(2.20±0.18)个]均高于对照组[97.9%、96.4%、(5.73±0.82)分、(2.19±0.17)个],但差异无统计学意义(P>0.05)。不同年龄及胚胎评分比较时,两组临床妊娠率比较差异无统计学意义(P>0.05)。观察组胚胎种植率(60.0%)、妊娠率(49.3%)、多胎率(43.5%)均明显高于对照组(44.3%、36.4%、21.6%),观察组流产率(7.2%)明显低于对照组(19.6%),差异均有统计学意义(P<0.05或P<0.01)。结论激光透明带打孔和激光透明带薄化辅助孵化方法均是冻融胚胎移植的有效方法 ,其中激光透明带薄化辅助孵化方法可进一步提高冻融胚胎的种植率和妊娠率,值得临床推广使用。更多还原

【Abstract】 Objective To investigate application effect of laser zona drilling and laser zona pellucida thinning assisted hatching methods in frozen thawed embryo transfer. Methods 280 patients with remaining available embryo cryopreservation in fertilization embryo in vitro transfer cycles from October 2011 to October 2013 in Maternity and Child Care Centers of Foshan City were selected as research objects, which were randomly divided into two groups, 140 cases treated with laser zona drilling assisted hatching as control group, 140 cases treated laser zona pellucida thinning assisted hatching as observation group. Frozen thawed embryo implantation and pregnancy were compared between two groups. Clinical pregnancy rate were analyzed in different age and different embryo score. Results Recovery rate(98.6%), complete embryo rate(97.1%), morphological evaluation of embryos [(5.84±0.96) points], embryos transferred number(2.20±0.18) in the observation group were higher than those of the control group [97.9%, 96.4%,(5.73 ±0.82)points,(2.19±0.17)], but it had no statistically significant difference between two groups(P > 0.05). Pregnancy rate of patients with different age and embryo score in the two groups had no statistically significant difference(P > 0.05). Embryo implantation rate(60.0%), clinical pregnancy rate(49.3%), multiple pregnancy rate(43.5%) in the observation group were significantly higher than those of the control group(44.3%, 36.4%, 21.6%); abortion rate(7.2%) in observation group was significantly lower than that of the control group(19.6%), the differences were statistically significant(P < 0.05 or P < 0.01). Conclusion Laser zona drilling and laser zona pellucida thinning assisted hatching methods are effective methods in frozen thawed embryo transfer. Laser zona pellucida thinning assisted hatching method can further improve implantation rate and pregnancy rate of frozen thawed embryo. It is worthy of clinical application.更多还原