二次玻璃化冻融胚胎对临床妊娠结局的影响  

Effect of secondary vitrified thawing on clinical outcome of thawed embryo transfer

作　　者：周学亮 毛玉玲 杜红姿[1] 陈仕萍[1] ZHOU Xueliang;MAO Yuling;DU Hongzi;CHEN Shiping(Center for Reproductive Medicine,the Third Affiliated Hospital,Guangzhou Medical University,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院生殖医学中心,广州510150

出　　处：《实用医学杂志》2020年第17期2385-2389,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金青年项目(编号:81701414)。

摘　　要：目的探讨胚胎二次玻璃化冻融复苏后移植对临床妊娠结局的影响。方法回顾性分析2014年1月至2018年12月行二次冻融复苏囊胚移植周期620例(双冻组),以同期单次冻融复苏周期囊胚移植周期11904例中选取与双冻周期基本资料匹配的1250例(单冻组)作为对照,比较两组间复苏率、着床率、临床妊娠率、多胎率、早期流产率、流产率、异位妊娠率等指标。结果双冻组着床率显著低于单冻组,差异有统计学意义(36.9%vs.50.1%,P<0.05);双冻组临床妊娠率显著低于单冻组,差异有统计学意义(43.1%vs.62.8%,P<0.05);两组间多胎率、单卵双胎率、早期流产率、流产率和异位妊娠率差异无统计学意义(P>0.05)。两组间早产、活产、死产、平均孕周和出生婴儿平均体质量差异无统计学意义(P>0.05)。结论二次冻融在一定程度上会降低胚胎的种植率,但仍有较高的着床妊娠能力,双冻囊胚仍有43.1%的妊娠率。同时,双冻并未提高如流产、多胎等不良妊娠结局发生几率。对于因意外原因导致不能及时移植或移植后剩余的胚胎,是一种较为安全有效的选择。Objective To evaluate the pregnancy outcome of repeated cryopreservation by vitrification ofhuman blastocysts.MethodsTo retrospectively analyze double frozen embryo resuscitation transplantation whichhas 620 cycles with refrozen blastocyst in our hospital from January 2014 to December 2018(double-freezinggroup),while a total number of 1240 selected from 11904 of blastocyst in single freeze-thaw recovery cycles in thesame period as control group.To compare embryos survival rate,embryo implantation rate,clinical pregnancyrate,multiple pregnancy rate,early spontaneous abortion rates,spontaneous abortion rates,ectopic pregnancyrate between double frozen group and single frozen group.ResultsFor cleavage embryo,there were no statisticaldifferences in embryos survival rate,embryo implantation rate,clinical pregnancy rate,multiple pregnancy rate,monozygotic twins rate,early spontaneous abortion rates and spontaneous abortion rates between frozen and refroz-en(P>0.05).For transplanted blastocyst,there were no statistical differences in embryos survival rate,clinicalpregnancy rate,single pregnancy rate,spontaneous abortion rates,ectopic pregnancy rate(P>0.05),and therewere statistical differences in embryo implantation rate,multiple pregnancy rate,early spontaneous abortion ratesbetween frozen and refrozen(P<0.05).ConclusionsDouble freezing-thawing can reduce embryo implantationability to some extent,but there is still an acceptable implantation and pregnancy rate,for blastocyst,which thepregnancy rate can reach 43.1%.At the same time,double freezing-thawing did not improve adverse pregnancy out-comes,such as abortion and multiple pregnancies.It is a safe option for embryos that cannot be transplanted intime for accident causes or those remain after transplantation.

关 键 词：玻璃化冷冻 二次冻融 体外受精 妊娠结局 

分 类 号：R321.3[医药卫生—人体解剖和组织胚胎学]