激光辅助孵化对人类胚胎玻璃化冻融后经不同时间培养移植临床结局的影响  

Effect of Laser-Assisted Hatching on the Clinical Outcomes of Human Vitrified-Thawed Embryo Transfer Cycles with Different Post-Thaw Culture Duration

作　　者：罗阳[1] 李磊[1] 孙源[1] LUO Yang;LI Lei;SUN Yuan(Department of Obstetrics and Gynecology,Center for Reproductive Medicine,Key Laboratory for Major Obstetric Diseases of Guangdong Province,Key Laboratory for Reproductive Medicine of Guangdong Province,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510150,China)

机构地区：[1]广州医科大学附属第三医院妇产科生殖医学中心,广东省产科重大疾病重点实验室,广东省生殖医学重点实验室,广东广州510150

出　　处：《实用妇产科杂志》2022年第7期544-548,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨激光辅助孵化(LAH)对人类玻璃化冻融胚胎移植(FET)解冻后经不同时间培养移植的影响。方法:回顾性分析在本生殖中心实施玻璃化FET的1225例患者的临床资料,其中行LAH 612例(LAH组),未行LAH 613例(对照组),并根据冻融后培养时间的不同分为培养4~5小时的短期培养组(LAH组205例,对照组201例),培养20~24小时的过夜培养组(LAH组197例,对照组203例)和培养44~48小时的囊胚培养组(LAH组210例,对照组209例)。比较不同培养时间两组患者特征及临床结局。结果:短期培养后,LAH组的胚胎植入率、临床妊娠率、活产率、分娩孕周、早产率及新生儿出生体质量与对照组比较,差异均无统计学意义(P>0.05)。过夜培养后,与对照组比较,LAH组的临床妊娠率(40.1%vs 37.4%)、活产率(33.0%vs 30.5%)明显升高(P<0.05)。囊胚培养后,与对照组比较,LAH组的胚胎植入率(59.0%vs 53.9%)、临床妊娠率(68.6%vs 64.1%)和活产率(56.7%vs 53.6%)均明显升高(P<0.05)。结论:LAH能改善FET周期患者经过夜培养和囊胚培养的临床结局。无论冻融后的培养时间,LAH都没有增加围产期结局的风险。Objective:To investigate the effect of laser assisted hatching(LAH)onhuman vitrified-thawed embryoswith different post-thaw culture duration in frozen embryo transfer(FET)cycles.Methods:The clinical data of 1225 patients who underwent vitrified FET in our reproductive center were retrospectively analyzed,including 612 patients who underwent LAH(LAH group)and 613 patients who did not undergo LAH(control group).According to the duration of post-thaw culture in FET cycles,these patients were divided into three subgroups:the short culture(4-5 h)group(LAH,n=205;control,n=201),overnight culture(20-24 h)group(LAH,n=197;control,n=203),and blastocyst culture(44-48 h)group(LAH,n=210;control,n=209),respectively.The characteristics and clinical outcomes were compared under different culture times.Results:In the short culture subgroup,no statistically significant differences were found in the implantation rate,clinical pregnancy rate,live birth rate,delivery gestational weeks,premature birth rate and neonatal birth weight between LAH group and control group(P>0.05).After overnight culture,the clinical pregnancy rate(40.1%vs 37.4%)and live birth rate(33.0%vs 30.5%)of LAH group were significantly higher than those of the control group(P<0.05).After blastocyst culture,compared with the control group,the embryo implantation rate(59.0%vs 53.9%),clinical pregnancy rate(68.6%vs 64.1%)and live birth rate(56.7%vs 53.6%)in LAH group were significantly higher(P<0.05).Conclusions:LAH can improve the clinical outcomes in FET cycles after overnight and blastocyst culture.And LAH did not increase the risk of perinatal outcome,irrespective of the post-thaw culture duration.

关 键 词：激光辅助孵化 玻璃化冻融胚胎 短期培养 过夜培养 囊胚培养 

分 类 号：R321.33[医药卫生—人体解剖和组织胚胎学]