摘要
目的观察体外受精-胚胎移植治疗周期中形态学低等级胚胎培养形成囊胚情况及其临床结局。方法采用序贯培养法培养D3移植和冷冻后废弃的形态学低等级胚胎,观察不同年龄组(年龄≤30岁组、>30且≤35岁组和>35岁组)囊胚形成情况,并利用低等级胚胎囊胚形成情况对体外受精妊娠结局进行预测;将形成的囊胚利用玻璃化法冷冻保存,观察囊胚解冻后的临床结局,并与直接冷冻低等级胚胎的解冻效果比较。结果共收集745例治疗周期的3249个低等级胚胎继续培养,有312例(41.88%)周期形成444个(13.67%)囊胚,其中>35岁组的周期培养成功率和囊胚形成率最低(P<0.05);低等级胚胎中有囊胚形成者的临床妊娠率高于无囊胚形成者(P<0.05);有130例囊胚解冻周期,共解冻196个囊胚,有184个(93.90%)囊胚复苏存活,共进行了120例移植周期,有43例(35.83%)临床妊娠;比较胚胎复苏存活率、移植周期取消率以及临床妊娠率,继续培养形成囊胚解冻组均明显优于低等级胚胎直接冷冻组(P<0.05)。结论 D3低等级胚胎具有不同程度的发育潜能,通过继续培养冷冻囊胚可以提高患者的累积妊娠率。
Objective： To investigate the blastocyst formation and clinical outcomes of low-grade embryos determined by morphological scoring after sequentially cultured and cryopreserved during in vitro fertilization-embryo transfer （IVF-ET）. Methods： The remaining low-grade embryos after D3 transplantation were sequentially cultured and cryopreserved or directly cryopreserved. The low-grade embryos which were sequentially cultured and cryopreserved were divided into 3 groups by age （≤30, 30-35, 〉35 years）. The blastocyst formation and the pregnancy outcomes of low-grade embryos were observed and compared. Results： A total of 3,249 low-grade embryos were collected from 745 treatment cycles. Four hundred and forty-four blastocysts （13. 67%） were formed in 312 cycles （41. 88%）. Among them, the lowest blastocyst formation rate and cycle culture success rate were in 〉35 years group （P〈0.05）. The clinical pregnancy rate in the blastocyst formation cases was higher than that in no blastocyst formation cases （P〈 0.05）. One hundred and ninety-six blastocysts were thawed and 184 were survived （93. 90%） in 130 blastocyst formation cycles. Forty-three cycles （35. 83%） got clinical pregnancy in 120 transfer cycles. The higher survival rate of embryos after thawing, lower cycle cancellation rate and higher clinical pregnancy rate were found in the blastocyst formation group than in the low-grade embryos directly cryopreserved group （P〈0.05）. Conclusions. D3 low-grade embryos have different degrees of development potential. When the low- grade embryos were sequentially cultured to blastocysts and cryopreserved, it could improve the cumulative pregnancy rate.
出处
《生殖医学杂志》
CAS
2012年第3期205-208,共4页
Journal of Reproductive Medicine
关键词
低等级
胚胎
囊胚
继续培养
Low-grade
Embryo
Blastocyst
Sequential culture
