冷冻方法对人卵裂期冷冻胚胎移植周期妊娠结局的影响  

Comparing clinical outcome of different methods for cryopreservation of human cleavage stage embryos

作　　者：郐艳荣[1] 王晟[1] 张凯[1] 曾诚[1] 薛晴[1] 尚鶄[1] 贺占举[2] 杨慧霞[1] 徐阳[1] 

机构地区：[1]北京大学第一医院妇产科 [2]北京大学第一医院泌尿科,北京100034

出　　处：《解剖学报》2017年第4期482-487,共6页Acta Anatomica Sinica

摘　　要：目的探讨慢速冷冻和玻璃化冷冻方法对人卵裂期冷冻胚胎移植周期妊娠结局的影响。方法回顾性分析2011年1月~2015年12月在北京大学第一医院进行卵裂期冷冻胚胎移植的1331个周期,包括慢速冷冻周期431个和玻璃化冷冻周期900个,比较两种不同冷冻方法的胚胎复苏率、完整胚胎率、临床妊娠率、种植率、流产率等各项指标,并分析卵裂球损伤对胚胎发育潜能的影响。结果玻璃化冷冻的胚胎复苏率(92.53%)、完整胚胎率(75.43%)、临床妊娠率(45.72%)、种植率(27.41%)高于慢速冷冻(76.93%、48.46%、39.52%、19.88%,P<0.05);而流产率分别为12.20%、12.56%(P>0.05);周期取消率分别为3.71%、1.33%(P<0.05)。慢速冷冻移植0、1、2、3个无卵裂球损伤胚胎的临床妊娠率分别为:36.2%、37.7%、42.0%、44.3%(P>0.05);玻璃化冷冻移植0、1、2、3个无卵裂球损伤胚胎的临床妊娠率分别为:20.5%、42.3%、48.8%、54.1%(P<0.05)。结论玻璃化冷冻法更适合于人卵裂期胚胎冷冻保存,其冷冻胚胎移植周期的妊娠结局要优于慢速冷冻法;卵裂球损伤对玻璃化冷冻复苏胚胎的发育潜能影响较大。Objective To compare clinical outcome of different methods for cryopreservation of human cleavage stage embryos. Methods The data of 1331 cleavage stage frozen-thawed embryo transfer cycles including 431 slowfreezing cycles and 900 vitrification cycles were retrospectively analyzed in Pecking First Hospital from January 2011 to December 2015. The survival rate,intact embryo rate,clinical pregnancy rate,implantation rate,cycle cancel rate and miscarry rate of differentmethod for cryopreservation of human cleavage stage embryos were compared. Results The survival rate（ 92. 53%）,intact embryo rate（ 75. 43%）,clinical pregnancy rate（ 45. 72%）,and implantation rate（ 27. 41%） of vitrification were all higher than those of slow-freezing（ 76. 93%,48. 46%,39. 52%,and 19. 88%,respectively; P 〈 0. 05）,but there was no difference between the miscarriage rate（ 12. 20%; P 〉 0. 05） and the cycle cancel（ 12. 56%; P 〉 0. 05）. The clinical pregnancy rate of transfer 0,1,2,3 intact embryos after slow-freezing were36. 2%,37. 7%,42. 0%,and 44. 3%（ P 〉 0. 05）,respectively,and those after vitrification were 20. 5%,42. 3%,48. 8%,and 54. 1%（ P 〈 0. 05） respectively. Conclusion Vitrification is a more effective means of cryopreserving human cleavage stage embryo than conventional slow freezing. There is no effect of cell loss on the freezing embryo development potency after slow-freezing,but cell loss affects the freezing embryo development potency after vitrification.

关 键 词：临床妊娠 冷冻胚胎移植 慢速冷冻 玻璃化冷冻 人 

分 类 号：R715.5[医药卫生—妇产科学]