不同质量卵裂期胚胎解冻后培养时间与妊娠结局的关系分析  

Association between culture time after embryo thawing and pregnancy outcome in cleavage embryos with different quality

作　　者：陈颖 柯雪 滕文顶 张攀 CHEN Ying;KE Xue;TENG Wen-ding;ZHANG Pan(Center for Reproductive Medicine,Chengdu Women’s&Children’s Central Hospital,School of Medicine,University of Electronic Science&Technology of China,Chengdu 610091)

机构地区：[1]电子科技大学医学院附属妇女儿童医院成都市妇女儿童中心医院生殖医学中心,成都610091

出　　处：《生殖医学杂志》2022年第7期905-910,共6页Journal of Reproductive Medicine

摘　　要：目的探讨玻璃化冷冻的卵裂期胚胎解冻后的培养时间与妊娠结局的关系。方法选择2019年1月至2020年12月期间,我中心492个卵裂期冻融胚胎移植周期(患者年龄<35岁)作为研究对象。根据解冻前胚胎评级分为A组(有优胚组,n=221)和B组(无优胚组,n=271),两组再根据胚胎解冻后距离移植的时间各分为两个亚组,即培养2 h的A1组(n=96)和B1组(n=123),培养18 h的A2组(n=125)和B2组(n=148),比较各组中胚胎解冻后不同培养时间亚组间临床妊娠率、着床率、活产率、早期流产率及异位妊娠率的差异。结果(1)有优胚组亚组间比较,A1组临床妊娠率、着床率显著高于A2组(分别为72.92%vs.57.60%,48.99%vs.38.43%,P<0.05);A1组活产率高于A2组(56.25%vs.50.40%)但无显著差异(P>0.05),亚组间异位妊娠率和早期流产率亦无显著差异(P>0.05)。(2)无优胚组亚组间比较,临床妊娠率、着床率、活产率、早期流产率及异位妊娠率均无显著差异(P>0.05)。(3)Logistic回归分析表明,有优胚组胚胎解冻后培养时间是临床妊娠率的独立影响因素[OR=1.972,95%CI(1.090,3.566),P<0.05]。结论优质卵裂期胚胎解冻后培养2 h移植,可能获得更好的妊娠结局,而非优质卵裂期胚胎解冻后培养时间对妊娠结局无明显影响。Objective:To investigate the association between culture time after embryo thawing and pregnancy outcome in frozen-thawed cleavage embryo transfer cycles.Methods:A total of 492 frozen-thawed cleavage embryo transfer cycles of patients younger than 35 years in our hospital from January 2019 to December 2020 was included in this study.The cycles were divided into group A(high-quality embryo group)and group B(non-high-quality embryo group)according to pre-freezing embryo assessment.According to the post-thawing culture time,the cycles were further divided into two subgroups:group A1(n=96)&group B1(n=123)(culture for 2 hours),and group A2(n=125)&group B2(n=148)(culture for 18 hours).The clinical pregnancy rate,implantation rate,live birth rate,early miscarriage rate and ectopic pregnancy rate were compared among the groups.Results:(1)Comparison between subgroups of high-quality embryos,the clinical pregnancy rate(72.92%vs.57.60%)and implantation rate(48.99%vs.38.43%)in group A1 was significantly higher than those in group A2(P<0.05).The live birth rate of group A1 was higher than that of group A2(56.25%vs.50.40%),but there was no significant difference(P>0.05).There was no significant difference in ectopic pregnancy rate and early abortion rate between subgroups(P>0.05).(2)Comparison between subgroups of non-high-quality embryos,there were no significant differences in clinical pregnancy rate,implantation rate,live birth rate,early abortion rate and ectopic pregnancy rate between subgroups of non-high-quality embryos(P>0.05).(3)Logistic regression analysis showed that the culture time after embryo thawing of high-quality embryos was an independent factor affecting the clinical pregnancy rate[OR=1.972,95%CI(1.090,3.566),P<0.05].Conclusions:Transplantation of high-quality cleavage embryos cultured for 2 hours after thawing may achieve better pregnancy outcome,while the post-thawing culture time may have no significant effect on non-high-quality embryos at cleavage stage.

关 键 词：卵裂期胚胎 解冻培养时间 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]