二次玻璃化冻融囊胚对临床结局和新生儿结局的影响  

Effect of secondary vitrification-thawed blastocysts on clinical outcome and neonatal outcome

作　　者：韩潇 毕钡钡 黄鲜菊 胡琳莉[1] HAN Xiao;BI Bei-bei;HUANG Xian-ju;HU Lin-li(Center for Reproductive Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院生殖医学中心,郑州450052

出　　处：《生殖医学杂志》2021年第9期1169-1174,共6页Journal of Reproductive Medicine

基　　金：国家重点研发计划(2019YFA0110900);河南省科技攻关计划(182102310136)。

摘　　要：目的研究胚胎经历二次玻璃化冻融后的临床结局及新生儿结局。方法回顾性分析2017年1月至2020年4月在本院生殖医学中心接受二次冻融复苏单囊胚移植的患者资料(双冻组,n=49),使用1∶3倾向性评分匹配选取同期进行常规单次冻融复苏单囊胚移植的患者作为对照组(单冻组,n=147)。比较两组患者的一般情况、着床率、临床妊娠率、流产率、异位妊娠率、多胎妊娠率和活产单胎新生儿结局。结果双冻组与单冻组之间的基本资料及着床率、临床妊娠率、流产率、异位妊娠率、多胎妊娠率均无统计学差异(P>0.05);两组间新生儿的性别比例、早产率、新生儿出生体重、低出生体重率、新生儿疾病发生率也均无统计学差异(P>0.05);与单冻组比较,双冻组的剖宫产率(100%vs.68.8%,P=0.030)显著升高、孕周[(37.9±0.8)vs.(39.0±1.1),P=0.002]显著下降。结论胚胎二次玻璃化冻融在一定程度上会缩短孕周,但对妊娠结局和新生儿结局没有显著的不利影响,是一种较为安全有效的选择。Objective:To investigate the clinical outcome and neonatal outcome of twice vitrification-thawed blastocyst.Methods:The data of patients who underwent single twice vitrification-thawed blastocyst transplantation(twice vitrification-thawed group,n=49)at the First Affiliated Hospital of Zhengzhou University Reproductive Medicine Center from January 2017 to April 2020 were retrospectively analyzed,and the patients who underwent single once vitrification-thawed blastocyst transplantation during the same period were selected as the control group with a 1∶3 propensity score matching(once vitrification-thawed group,n=147).The general data,implantation rate,clinical pregnancy rate,miscarriage rate,ectopic pregnancy rate,multiple pregnancy rate and neonatal outcome of live birth singleton were compared between the two groups.Results:There were no significant differences in the implantation rate,clinical pregnancy rate,miscarriage rate,ectopic pregnancy rate,and multiple pregnancies between the twice vitrification-thawed group and once vitrification-thawed groups.There were also no significant differences in the sex ratio of newborns,preterm birth rate,neonatal birth weight,low birth weight rate,or incidence of neonatal diseases between the two groups(P>0.05).The cesarean delivery rate was significantly higher in the twice vitrification-thawed group than that in the once vitrification-thawed group(100%vs.68.8%.P=0.030),and the gestational week was significantly shorter in the twice vitrification-thawed group than in the once vitrification-thawed group[(37.9±0.8)vs.(39.0±1.1),P=0.002].Conclusions:Twice vitrification-thawed of embryos shortens the gestational week to a certain extent,but has no significant adverse effects on pregnancy outcome or neonatal outcome,and it is a safer and more effective option.

关 键 词：二次冻融 玻璃化冷冻 单囊胚移植 妊娠结局 新生儿结局 

分 类 号：R711.6[医药卫生—妇产科学]