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目的研究玻璃化冻融胚胎解冻后过夜培养与妊娠结局的相关性。方法回顾性分析2014年于哈尔滨医科大学附属第一医院生殖中心行冻融胚胎移植(frozen-thawed embryo transfer,FET)治疗的周期,共936例,依据胚胎移植前是否过夜培养,将其分为两组。A组为解冻后过夜培养移植组,共856例;B组为解冻当日移植组,共80例。依据过夜培养后胚胎是否生长,将A组继续分为A1组:全部胚胎均生长,共499例;A2组:部分胚胎生长,共301例;A3组:无胚胎生长,共56例。将A1组按移植胚胎个数分为Aa组:移植3个胚胎,共173例;Ab组:移植少于3个胚胎,共326例。比较各组患者年龄、内膜厚度、胚胎复苏率、临床妊娠率、种植率。结果 A组与B组临床妊娠率(35.86%、33.75%)和种植率(19.13%、13.95%)差异无统计学意义(P>0.05)。A1组临床妊娠率和种植率(42.69%、24.03%)均高于A2(26.91%、12.94%)和A3组(23.21%、13.45%)(P<0.05)。Aa、Ab组在临床妊娠率(41.62%、43.25%)和多胎率(26.38%、25.71%)方面差异无统计学意义(P>0.05),Ab组较Aa组有更高的胚胎种植率(28.85%vs18.3%)和更低的3胎率(0.71%vs 5.88%)。结论过夜培养后继续生长的胚胎有更高的临床妊娠率与胚胎种植率,增加移植的胚胎个数不能改善临床妊娠结局。
Objective To study the correlation between vitrification and thawing embryo thawing after overnight thawing. Methods A retrospective analysis was performed on the cycles of frozen-thawed embryo transfer (FET) in the Reproductive Center of the First Affiliated Hospital of Harbin Medical University in 2014. A total of 936 cases were divided according to whether they were cultured overnight before embryo transfer Two groups. In group A, 856 cases were transplanted overnight after thawing, while in group B, 80 cases were transplanted on the day of thawing. According to the growth of embryos after overnight culture, group A was further divided into A1 group: all the embryos were grown, a total of 499 cases; A2 group: some embryos, a total of 301 cases; A3 group: no embryo growth, a total of 56 cases. According to the number of embryos transferred in group A1, group Aa was divided into three groups: three embryos were transplanted in total, 173 cases in total. Group Ab: 326 embryos were transplanted in less than three embryos. The age, intima thickness, embryo recovery rate, clinical pregnancy rate and implantation rate of each group were compared. Results The clinical pregnancy rate (35.86%, 33.75%) and implantation rate (19.13%, 13.95%) in group A and group B had no statistical significance (P> 0.05). The clinical pregnancy rate and implantation rate in group A1 were significantly higher than those in A2 (26.91%, 12.94%) and A3 (23.21%, 13.45%) (42.69% and 24.03%, P <0.05). There was no significant difference in clinical pregnancy rate (41.62%, 43.25%) and multiple birth rate (26.38%, 25.71%) between Aa and Ab groups (P> 0.05). Ab group had higher embryo implantation rate than Aa group 28.85% vs18.3%) and lower 3-birth rate (0.71% vs 5.88%). CONCLUSIONS: Embryos that continue to grow after overnight culture have a higher rate of clinical pregnancy and embryo implantation, and increasing the number of transplanted embryos does not improve clinical pregnancy outcomes.