胚胎冻融对卵裂期行植入前遗传学诊断或筛查后可移植胚胎临床结局的影响  

Effects of embryo cryopreservation and thawing on clinical outcomes of transplantable embryos after cleavage-stage preimplantation genetic diagnosis or screening

作　　者：石碧炜[1] 崔龙[1] 叶晓群[1] 叶英辉[1] 

机构地区：[1]浙江大学医学院附属妇产科医院生殖内分泌科生殖遗传教育部重点实验室,浙江杭州310006

出　　处：《浙江大学学报（医学版）》2017年第3期295-299,共5页Journal of Zhejiang University(Medical Sciences)

基　　金：国家自然科学基金(81370761)

摘　　要：目的:探讨胚胎冻融对卵裂期胚胎行植入前遗传学诊断或筛查后可移植胚胎临床结局的影响。方法:回顾2011年1月至2016年12月在浙江大学医学院附属妇产科医院行植入前遗传学诊断或筛查的302个周期,分析其病例组成,比较其中新鲜胚胎组(n=184)与冻融胚胎组(n=118)的移植妊娠率、着床率、活产率和流产率,并分析妊娠结局的影响因素。结果:新鲜胚胎组正常或平衡易位胚胎检出率高于冻融胚胎组,平均移植胚胎个数多于冻融胚胎组,差异有统计学意义(均P<0.05);新鲜胚胎组的妊娠率、着床率和活产率低于冻融胚胎组,而流产率高于冻融胚胎组,但差异均无统计学意义(均P>0.05)。多因素logistic回归分析结果显示,女方年龄、男方年龄、胚胎类型、植入前遗传学诊断或筛查方式和病因对妊娠结局均无影响(均P>0.05)。结论:卵裂期胚胎冷冻复苏对植入前遗传学诊断或筛查后可移植胚胎的临床结局无显著影响。Objective：To investigate the effects of embryo cryopreservation and thawing on clinical outcomes of transplantable embryos after preimplantation genetic diagnosis （PGD） or preimplantation genetic screening （PGS） in cleavage-stage. Methods：The clinical data of 302 cases （including 118 cases using frozen/thawing embryos and 184 cases using fresh embryos） undergoing PGD/PGS in Women＇s Hospital, Zhejiang University School of Medicine during January 2011 and December 2016 were retrospectively analyzed. The pregnancy rate, implantation rate, live birth rate and abortion rate of fresh and frozen-thawed embryo transfer （FET） cycles were compared. And the influencing factors for pregnancy outcome was analyzed by multivariate logistic regression. Results：The rate of normal or balanced translocation embryos in fresh cycle was higher than that in FET cycle （23.52% vs 16.67%, P〈0.05）, and the average number of transplanted embryos was more than that in FET cycle （1.54±0.56 vs 1.33±0.51, P〈0.05）. But there were no significant differences in pregnancy rate （36.42% vs 40.00%, P〉0.05）, implantation rate （26.62% vs 32.91%, P〉0.05）, abortion rate （19.44% vs 8.33%, P〉0.05） and live birth rate （25.96% vs 28.33%, P〉0.05） between fresh cycle and FET cycle. Multivariate logistic regression showed that, parent ages, embryo status （fresh or frozen）, the mode of PGD/PGS and the findings of PGD/PGS had no impact on pregnancy outcome （all P〉0.05）. Conclusion：Cryopreservation do not have significant effects on the clinical outcomes of transplantable embryos after PGD/PGS in cleavage-stage.

关 键 词：低温保存 胚胎移植 受精 体外 分裂期 卵 流产 自然/病因 妊娠结局 植入前诊断 遗传筛查 

分 类 号：R714.8[医药卫生—妇产科学]