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目的:探讨全囊胚玻璃化冷冻的临床价值。方法:回顾分析2010年1月至2012年12月在河南省人民医院生殖医学研究所行体外受精-胚胎移植(IVF-ET),且因OHSS高危倾向行全胚玻璃化冷冻复融移植周期的不孕患者的临床资料。根据冷冻和培养方式分为A组(复融胚胎移植,784例)、B组(复融囊胚移植,199例)和C组(复融胚胎行囊胚培养后移植,124例)。比较3组患者的基本资料、IVF治疗的妊娠结局。结果:C组患者中3例因未形成囊胚而取消周期,其余121例患者移植后有33枚囊胚需再次冷冻。3组患者的平均移植胚胎数、种植率、临床妊娠率、多胎率、早期流产率比较,差异显著(P<0.05)。B、C组患者的种植率、妊娠率、多胎率均显著高于A组(P<0.05),平均移植胚胎数、早期流产率均显著少于A组(P<0.05)。结论:对可能发生OHSS的全胚冷冻患者,胚胎个数较多时,行囊胚培养后玻璃化冷冻,择期复融移植能提高患者的种植率和妊娠率,同时也减少了患者的费用,是目前最佳的冷冻策略和最有益的冷冻方案。
Objective: To investigate the clinical value of vitrification of vitrified embryos. Methods: Retrospective analysis of IVF-ET in Reproductive Medicine Institute of Henan Provincial People’s Hospital from January 2010 to December 2012 and retrograde vitrification and allograft cycle in high-risk OHSS Infertility patients with clinical data. According to the methods of freezing and culture, group A was divided into group A (784 cases of fusion embryo transfer), group B (group of complex blastocyst transfer, 199 cases) and group C (group of reconstructed embryos after blastocyst culture, 124 cases). The basic data of 3 groups of patients were compared, and the pregnancy outcome of IVF treatment was compared. Results: Three patients in group C canceled the cycle without forming blastocysts, and the remaining 121 patients had 33 blastocysts to be frozen again after transplantation. The average number of embryos transferred, implantation rate, clinical pregnancy rate, multiple birth rate and early miscarriage rate in the three groups were significantly different (P <0.05). The implantation rate, pregnancy rate and multiple birth rate in group B and C were significantly higher than those in group A (P <0.05). The average number of embryos transferred and abortion rate in group B was significantly less than that in group A (P <0.05). CONCLUSIONS: When the number of embryos is high in OHSS-prone whole-body frozen patients, vitrified blastocysts after vitrification and elective transplantation may improve the implantation rate and pregnancy rate and reduce the cost of patients, which is the current The best freezing strategy and the most beneficial freezing program.