摘要
目的:探讨着床前遗传学诊断(PGD)后囊胚冻融的特点及临床应用。方法:①实验研究:对41枚PGD诊断为遗传学异常的废弃囊胚进行冻融研究,其中27枚囊胚进行程序化冻融,14枚囊胚进行玻璃化冻融。分别观察囊胚冷冻前及解冻后的形态学特点,比较2种冻融方法的囊胚解冻复苏率。②临床应用:对14对夫妇在PGD新鲜周期移植后仍有剩余的遗传诊断正常的40枚囊胚给予冷冻保存。其中,6对夫妇的12枚胚胎进行了解冻移植。结果:①实验研究:27枚进行程序化冻融的囊胚解冻后复苏22枚,复苏率为81.48%(22/27);14枚进行玻璃化冻融的囊胚解冻后复苏11枚,复苏率为78.57%(11/14),2种冻融方法的囊胚解冻复苏率无统计学差异(P>0.05)。无论何种冻融方法,解冻后复苏存活的囊胚在体外培养30 min均可以观察到复苏现象,体外培养4 h囊腔均扩张。②临床应用:14对有剩余囊胚冻存的夫妇中,6对夫妇新鲜周期即获得临床持续妊娠,另外还有1对夫妇早期自然流产,1对夫妇宫外孕。其余新鲜周期未孕的6对夫妇进行了囊胚解冻移植,其中3对夫妇解冻周期获得了临床妊娠。结论:经PGD诊断后的囊胚,无论是程序化冻融还是玻璃化冻融,均可以获得满意的解冻复苏率。PGD诊断后囊胚冻融技术的成熟与发展可以提高PGD夫妇的累积妊娠率。
Objective： To evaluate the features and the clinical application of the freezing-thawing of the blastocysts after preimplantation genetic diagnosis（PGD）.Methods： 1） Research part： A total of 41 PGD abnormal discard blastocysts were included in the research part,27 blastocysts were slow freezing and 14 blastocysts were vitrified.Morphology features were observed before blastocysts freezen and after their thawing.Blastocysts surviving rates were compared between the two freezing methods.2） Clinical part： there were 14 PGD cycles which have 40 surplus PGD normal blastocysts freezed,12 blastocysts of 6 PGD cycles were thawed,and 11 blastocysts were transferred.Results： 1） Research part： The survival rate of the slow freezing method was 81.48 %（22/27）,while it was 78.57 %（11/14） of the vitrification.There was no significant difference between the two methods.All the thawed blastocysts must be observed their survival morphology after thawing 30 min.When incubated 4 h,all the survival blastocysts were expanded.2） Clinical part： Of 14 PGD cycles which had surplus PGD normal blastocysts freezed,6 cycles were pregnant in the fresh cycles,besides 1 abortion and 1 ectopic pregnancy.Twelive blastocysts were thawed in 6 cycles,while 11 blastocysts were transferred.As a result,3 couples get clinical pregnancy.Conclusion： No matter what freezing-thawing method,a satisfied survival rate can be got from the blastocysts after PGD.Development of the blastocysts freezing-thawing techniques can increase the cumulative pregnancy rate.
出处
《生殖与避孕》
CAS
CSCD
2012年第3期199-204,共6页
Reproduction and Contraception
基金
国家自然基金资助,项目号:81070534/H0426
