冷冻方法对人卵裂期冷冻胚胎移植周期妊娠结局的影响

doi:10.16098/j.issn.0529-1356.2017.04.020

摘要/Abstract

摘要：

目的探讨慢速冷冻和玻璃化冷冻方法对人卵裂期冷冻胚胎移植周期妊娠结局的影响。方法回顾性分析2011年1月～2015年12月在北京大学第一医院进行卵裂期冷冻胚胎移植的1331个周期，包括慢速冷冻周期431个和玻璃化冷冻周期900个，比较两种不同冷冻方法的胚胎复苏率、完整胚胎率、临床妊娠率、种植率、流产率等各项指标，并分析卵裂球损伤对胚胎发育潜能的影响。结果玻璃化冷冻的胚胎复苏率(92.53%)、完整胚胎率(75.43%)、临床妊娠率(45.72%)、种植率(27.41%)高于慢速冷冻(76.93%、48.46%、39.52%、19.88%, P<0.05)；而流产率分别为12.20%、12.56%(P>0.05)；周期取消率分别为3.71%、1.33%(P<0.05)。慢速冷冻移植0、1、2、3个无卵裂球损伤胚胎的临床妊娠率分别为：36.2%、37.7%、42.0%、44.3%(P>0.05); 玻璃化冷冻移植0、1、2、3个无卵裂球损伤胚胎的临床妊娠率分别为：20.5%、42.3%、48.8%、54.1%(P<0.05)。结论玻璃化冷冻法更适合于人卵裂期胚胎冷冻保存，其冷冻胚胎移植周期的妊娠结局要优于慢速冷冻法；卵裂球损伤对玻璃化冷冻复苏胚胎的发育潜能影响较大。

关键词: 临床妊娠, 冷冻胚胎移植, 慢速冷冻, 玻璃化冷冻, 人

Abstract:

Objective To compare clinical outcome of different methods for cryopreservation of human cleavage stage embryos. Methods The data of 1331 cleavage stage frozen-thawed embryo transfer cycles including 431 slow-freezing cycles and 900 vitrification cycles were retrospectively analyzed in Pecking First Hospital from January 2011 to December 2015. The survival rate, intact embryo rate, clinical pregnancy rate, implantation rate, cycle cancel rate and miscarry rate of differentmethod for cryopreservation of human cleavage stage embryos were compared. Results The survival rate (92.53%), intact embryo rate (75.43%), clinical pregnancy rate (45.72%), and implantation rate (27.41%) of vitrification were all higher than those of slow-freezing (76.93%, 48.46%, 39.52%, and 19.88%, respectively; P<0.05), but there was no difference between the miscarriage rate (12.20%; P>0.05) and the cycle cancel (12.56%; P>0.05). The clinical pregnancy rate of transfer 0, 1, 2, 3 intact embryos after slow-freezing were 36.2%, 37.7%, 42.0%, and 44.3% (P>0.05), respectively, and those after vitrification were 20.5%, 42.3%, 48.8%, and 54.1% (P<0.05) respectively. Conclusion Vitrification is a more effective means of cryopreserving human cleavage stage embryo than conventional slow freezing. There is no effect of cell loss on the freezing embryo development potency after slow-freezing, but cell loss affects the freezing embryo development potency after vitrification.

Key words: Clinical pregnancy, Frozen thawed embryo transfer, Slow freezing, Vitrification, Human

郐艳荣王晟张凯曾诚薛晴尚鶄贺占举杨慧霞徐阳. 冷冻方法对人卵裂期冷冻胚胎移植周期妊娠结局的影响[J]. 解剖学报, 2017, 48(4): 482-487.

KUAI Yan-rong WAN Sheng ZHANG Kai ZENG Cheng XUE Qing SHANG Jing HE Zhan-ju YANG Hui-xia XU Yang. Comparing clinical outcome of different methods for cryopreservation of human cleavage stage embryos[J]. Acta Anatomica Sinica, 2017, 48(4): 482-487.

参考文献

［1］Trounson A，Morthr L． Human pregnancy following cryopreservation，thawing and transfer of an eight-cell stage embryo［J］. Nature, 1983, 305(5903): 707-709．

［2］Li Z, Wang YA, Ledger W, et al. Clinical outcomes following cryopreservation of blastocysts by vitrification or slow freezing: a population-based cohort study［J］. Hum Reprod, 2014, 29(12): 2794-2801.

［3］Jacob L, Oshrit L, Masha B, et al.Cryopreservation of day 2-3 embryos by vitrification yields better outcome than slow freezing［J］. Gynecol Endocrinol, 2014; 30(3): 202-204.

［4］Mojtaba RV, Poopak EY, Leita K, et al. Vitrification versus slaw freezing gives excellent survival, post warming embryo morphology and pregnancy outcomes for human cleaved embryos［J］. J Assist Reprod Genet, 2009, 26(6):347-354.

［5］Zheng AY, Ding J, Gu B, et al. The effect on the embryo development potency and clinical outcome between vitrification and programmed freezing methods［J］. Reproduction & Contraception, 2013，33(1)：-. (in Chinese)

郑爱燕,丁洁, 顾斌,等. 玻璃化冷冻与程序化冷冻对胚胎发育潜能及临床结局的影响［J］. 生殖与避孕，2013，33(1)：16-20.

［6］Xing GB, Qiu Y, Meng JP. The impact of different embryo cryopreservation methods on the clinical outcome offreezing-thawed embryo transfer patients［J］. Maternal and Child Health Care of China, 2011, 26(15): 2301-2302. (in Chinese)

幸贵邦, 丘彦, 孟江萍. 不同胚胎冷冻方法对冻融胚胎移植患者临床结局的影响［J］. 中国妇幼保健, 2011, 26(15): 2301-2302.

［7］Balaban B, Urman B, Ata B, et al.A randomized controlled study of human day 3 embryo cryopreservation by slow freezing or vitrification: vitrification is associated with higher survival, metabolism and blastocyst formation［J］. Hum Reprod, 2008, 23(9):1976-1982.

［8］Lane M, Maybach JM, Gardner DK. Addition of ascorbate during cryopreservation stimulates subsequent embryo development［J］. Hum Reprod, 2002, 17(10):2686-2693.

［9］Sheehan CB, Lane M, Gardner DK. The CryoLoop facilitatesre-vitrification of embryos at four successive stages of development without impairing embryo growth［J］. Hum Reprod, 2006, 21(11):2978-2984.

［10］Giovanna F, Nicolas F, Anne S V，etal. A randomized controlled trial comparing two vitrification methods versus slow-freezing for cryopreservation of human cleavage stage embryos［J］. J Assist Reprod Genet, 2014, 31(4):241-247.

［11］Kolibianakis E M, Venetis C A, Tarlatzis B C. Cryopreservation of human embryos by vitrification or slow freezing: which one is better［J］.CurrOpin Obstet Gynecol, 2009, 21(3): 270-274.

［12］Wang YF, Yu ChM, Yang HY, et al. Comparison and analysis of the maternal and neonatal outcomes of programmed freezing and vitrification for cleavage stage embryo transfer［J］. Journal of Reproductive Medicine, 2014, 23(1):11-15. (in Chinese)

王宇峰，于春梅，杨海燕，等.程序化冷冻与玻璃化冷冻卵裂期胚胎移植的母婴结局对照分析［J］. 生殖医学杂志，2014, 23(1):11-15.

［13］Xue YM, Li K, Ge HSh, et al. Comparision of the clinical outcome of day 2 and day 3 embryo after cryopreservation with vitrification and programmed freezing［J］. Journal of Medical Research, 2011, 40(3):44-48. (in Chinese)

薛亚梅, 李坤, 葛红山, 等. 程序化与玻璃化冷冻保存人D2和D3胚胎的临床结局比较［J］. 医学研究杂志, 2011, 40(3):44-48.

［14］El-Toukhy T, Khalaf Y, Al-Darazi K, et al. blastomere loss on the outcome of frozen embryo replacement cycles［J］. Fertil Steril, 2003, 79(5):1106-1111.

［15］Archer J, Gook D, Edgar H. Blastocyst formation and cell numbers in human.frozen-thawed embryos following extended culture［J］. Hum Reprod, 2003, 18(8):1669-1673.

［16］Edgar D, Archer J, McBain J, et al. Embryonic factors affecting outcome from single cryopreserved embryo transfer［J］. Reprod Biomed Online, 2007, 14(6):718-723.

［17］Zheng X, Liu P, Chen G,et al. Viability of frozen-thawed human embryos with one-two blastomere lysis［J］. J Assist Reprod Genet, 2008, 25(7):281-285.

［18］Van Landuyt L, Van de Velde H, De Vos A, et al. Influence of cell loss after vitrification or slow-freezing on furtherin vitro development and implantation of human Day 3 embryos［J］. Hum Reprod, 2013, 28(11): 2943-2949.

[1]	刘晓丽许琳吴爱雪闻彩云李如画吴安婷陈黛茜陈成春. 多发性硬化和视神经脊髓炎的脑灰质结构分析 [J]. 解剖学报, 2024, 55(1): 17-24.
[2]	白贺滕野冯蕾孟海伟汤煜春刘树伟. 基于空间域与频域特征自适应融合和类间边界区域增强的三维海马分割[J]. 解剖学报, 2024, 55(1): 73-81.
[3]	尹诗琴杨思艺王锐涵游贵宣杨迎秋张磊. 基于CT平扫下胫腓联合腓骨切迹分型及其临床意义[J]. 解剖学报, 2024, 55(1): 82-87.
[4]	杨洋史君李琨马渊张少杰侯二飞王超群陈杰王星李志军 . 切除不同范围钩突后颈椎椎间盘的有限元分析[J]. 解剖学报, 2024, 55(1): 88-97.
[5]	孙雷王星宇谢水华. 老年骨质疏松性胸腰椎压缩性骨折患者PKP术后再发骨折的风险分析及列线图预测模型的构建[J]. 解剖学报, 2024, 55(1): 98-104.
[6]	刘丽平朱梦妮徐慧 . 白细胞介素6对脂多糖诱导所致类子痫前期大鼠有核红细胞的影响 [J]. 解剖学报, 2023, 54(6): 722-729.
[7]	赵卫明李晓余国营王改平常翠芳 . 丝氨酸肽酶抑制因子Kazal型1对肝癌细胞增殖的影响及其机制 [J]. 解剖学报, 2023, 54(6): 695-702.
[8]	袁硕赵安全黄其日麦拉图吴海贺徐永胜齐岩松包呼日查 . 基于下肢全长CT分析胫骨平台后倾角和胫骨扭转角与复发性髌骨脱位的相关性 [J]. 解剖学报, 2023, 54(6): 703-709.
[9]	韩毅蔡力冯枭 . 脊柱骨质疏松性压缩性骨折经皮穿刺椎体成形后骨水泥渗漏风险分析及列线图预测模型的构建 [J]. 解剖学报, 2023, 54(6): 710-715.
[10]	王子善张兴华徐飞宇克莉郑连斌程瑜 . 云南布朗族、德昂族、佤族营养体格指数、肥胖状况及其高血压预警 [J]. 解剖学报, 2023, 54(6): 730-737.
[11]	席焕久李文慧 . 关于人种问题的讨论[J]. 解剖学报, 2023, 54(5): 605-614.
[12]	杜大鹏孙玉张敏王汉琴 . 切应力通过Pim1/Akt调节人脐静脉内皮细胞内皮型一氧化氮合酶Ser633和Ser1177位点磷酸化[J]. 解剖学报, 2023, 54(5): 546-552.
[13]	周春辉谢胜强王姜婷兰晓娟张剑宁赵虎林. 多模态电磁导航辅助新鲜尸头经鼻内镜的颅底解剖测量[J]. 解剖学报, 2023, 54(5): 560-566.
[14]	刘颜静史勇红. 基于FPFH-PointNet的术中膝关节软骨表面点云自动提取[J]. 解剖学报, 2023, 54(5): 553-559.
[15]	白芃李玮钟铧王展飞. 藏族正常成人头颅正中矢状面幕上和幕下面积的磁共振成像测量[J]. 解剖学报, 2023, 54(5): 567-574.