囊胚期冷冻胚胎移植的临床应用探讨

Clinical value of frozen-thawed blastocysts transfer

摘要:

目的探讨囊胚期冷冻胚胎移植的临床应用价值.方法对2002年10月～2003年12月在湘雅医院生殖医学中心接受囊胚培养并行囊胚期冷冻胚胎移植的病例进行分析,了解囊胚期与卵裂期冷冻胚胎解冻后的胚胎成活率、植入率及妊娠率.结果冷冻囊胚解冻后胚胎数、胚胎成活率、植入率和妊娠率与卵裂期冷冻胚胎无显著差别(P＞0.05),囊胚解冻后经15 h过夜培养,42枚中有22枚成活,其中8枚Ⅰ,Ⅱ级继续发育或囊胚腔扩张,3例获得妊娠,妊娠率为37.5%.结论囊胚期冷冻胚胎移植同样能达到卵裂期冷冻胚胎移植的临床效果,同时增加解冻与移植间隔时间可更好地选择冻融囊胚移植,对提高妊娠率可能有一定意义.

Abstract:

Objective: To investigate the clinical value of frozen-thawed blastocyst transfer. Methods: A retrospective analysis was performed on blastocyst culture and frozen-thawed blastocyst transfer cycles from October 2002 to December 2003 in Xiangya Hospital. The embryo survival rate, implantation and clinical pregnancy rate were estimated in frozen-thawed blastocysts and cleavage stage embryos. Results: The survival rate,implantation and clinical pregnancy rate of frozen-thawed blastocysts were 52.38%,19.05% and 37.5% respectively. There was no significant difference between frozen-thawed blastocysts and cleavage stage embryo (P>0.05). 22 of 42 thawed blastocysts survived and 8 thawed blastocysts grew and re-expansed by 15hr of culture before thawed blastocyst transfer. It resulted in 3 cases of clinical pregnancy. Conclusions: There is no significant difference in clinical pregnancy between frozen-thawed blastocysts and cleavage stage embryo transfer. Increasing the interval between thawing and transfer appears to be beneficial in order to better select for transfer frozen-thawed blastocysts.