人成熟卵母细胞玻璃化冻存时长对体外受精-胚胎移植结局的影响  

Effects of Cryostoragetime of Human Mature Oocytes on the Outcome of in Vitro Fertilization-Embryo Transfer

作　　者：王洋[1] 齐琳婧 刘涛[1] 陶立元[2] 牛子儒 严杰[1,4] 马彩虹 WANG Yang;QI Linjing;LIU Tao(Center for Reproductive Medicine,Peking University Third Hospital,Beijing 100191,China;Department of Gynecology,Beijing Northern Hospital of Weaponry Industry,Beijing 100089,China)

机构地区：[1]北京大学第三医院生殖医学中心,北京100191 [2]北京大学第三医院临床流行病学中心,北京100191 [3]兵器工业北京北方医院妇科,北京100089 [4]中国医学科学院卵成熟障碍综合诊治研究创新单元,北京100191

出　　处：《实用妇产科杂志》2020年第11期838-842,共5页Journal of Practical Obstetrics and Gynecology

基　　金：中国医学科学院医学与健康科技创新工程(编号:2019-I2M-5-001)。

摘　　要：目的:探讨玻璃化冷冻人成熟卵母细胞的时长是否会影响解冻后卵细胞的复苏率、受精率和临床妊娠结局。方法:回顾性分析2013年5月至2018年6月就诊于北京大学第三医院生殖医学中心行成熟卵母细胞玻璃化冷冻,随后进行解冻受精形成胚胎培养移植的110例患者114个冷冻卵母细胞周期的临床资料。根据卵细胞冻存时间分为3组,A组(冻存时间≤3个月)42例,B组(3个月<冻存时间≤12个月)42例,C组(冻存时间>12个月)30例,比较3组的卵细胞解冻复苏率、受精率、可利用胚胎率、优质胚胎率、临床妊娠率和活产率等指标。结果:114个冷冻卵母细胞周期中最短冻存时间4天,最长32个月,共行胚胎移植周期114个,其中新鲜胚胎移植周期77个,解冻胚胎移植周期37个。共解冻成熟卵母细胞1578枚,复苏率为77.69%(1226/1578)、受精率为69.35%(774/1116)、卵裂率为93.41%(723/774)、可移植胚胎率为42.19%(305/723)、优质胚胎率为33.06%(239/723)、每冻卵活产率为2.47%(39/1578)。3组年龄、不孕年限、基础卵泡刺激素(FSH)水平、窦卵泡数、解冻卵细胞数和男方精液情况等基本信息差异无统计学意义(P>0.05),而A组体质量指数(BMI)明显大于B组(P=0.038);3组的解冻复苏率、受精率、卵裂率、可利用胚胎率、优质胚胎率、临床妊娠率、早期流产率和活产率的差异均无统计学意义(P>0.05)。随访25例活产新生儿均未发现先天畸形。结论:人成熟卵母细胞的发育潜能不会随着冷冻时间的延长而减低,玻璃化冷冻卵母细胞可获得比较满意的复苏效果。Objective:To investigate whether the storage time of vitrification human mature oocytes affects the following recovery rate,fertilization rate and the pregnancy outcome.Methods:A retrospective study was conduc-ted with clinical data of 110 patients with 114 oocytes cryopreservation cycles from May 2013 to June 2018 in Center for Reproductive Medicine of Peking University Third Hospital.According to storage time,patients were di-vided into three groups,42 in group A were less or equal to 3 months,42 in group B were between 3 to 12 months,and 30 in group C were more than 12 months.Oocytes thawing recovery rate,fertilization rate,cleavage rate,available embryo rate,high quality embryo rate,pregnancy rate,early abortion rate and live birth rate were compared among the groups.Results:The shortest storage time is 4 days while the longest time is 32 months a-mong the 114 oocytes cryopreservation cycles.114 embryo transfer cycle were conducted within 77 fresh cycles and 37 frozen-thaw cycles.A total of 1578 mature oocytes were thawed,the recovery rate was 77.69%(1226/1578),the fertilization rate was 69.35%(774/1116),the cleavage rate was 93.41%(723/774),the a-vailable embryo rate was 42.19%(305/723),the high quality embryo rate was 33.06%(239/723),and each vitrified oocytes obtained live birth rate was 2.47%(39/1578).There was no significant difference in the age,dura-tion of infertility,basal-FSH,AFC,number of thawed oocyte and semen quality among the three group(P>0.05).However,the BMI in the group A was higher than group B(P=0.038).Moreover,there was no significant differ-ence in recovery rate,fertilization rate,cleavage rate,available embryo rate,high quality embryo rate,pregnancy rate,early abortion rate and live birth rate(P>0.05).No congenital malformations were detected in 25 live birth babies.Conclusions:The developmental potential of human mature oocytes does not decrease with the prolong of storage time.The vitrified cryopreservation of mature oocyte could achieve a satisfactory recovery outcome.

关 键 词：成熟卵母细胞 玻璃化冷冻 冻存时间 体外受精-胚胎移植 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]