单囊胚冻融周期中囊胚冷冻时期及冻融后囊胚再次扩张程度对临床结局影响.docVIP

单囊胚冻融周期中囊胚冷冻时期及冻融后囊胚再次扩张程度对临床结局影响 　　【摘要】目的：分析比较第5天（Day 5）、第6天（Day 6）的冻融单囊胚移植对妊娠结局的影响，探讨不同发育天数囊胚对冻融后胚胎的发育潜能和临床结局的影响，以及囊胚解冻后的扩张程度对临床结局的影响。方法：回顾性分析2012年10月至2014年10月在我院生殖中心行冻融单囊胚移植的患者211例，根据冷冻时间不同分为Day 5冷冻组（n=113）和Day 6冷冻组（n=98），比较两组患者的临床妊娠率，胚胎种植率和早期流产率。根据囊胚解冻后2小时囊腔的扩张程度分为：部分扩张组（n=54）、完全扩张组（n=105）、孵出组（n=52），比较三组患者的临床妊娠率，胚胎种植率，早期流产率。结果：Day 5冷冻组的临床妊娠率（6372%）和种植率（6372%）均显著高于Day 6冷冻组（4694%，4694%）（P005），Day 5冷冻组的流产率（1389%）低于Day 6冷冻组（1739%）；冻融后部分扩张组的临床妊娠率（4074%）和种植率（4074%）均显著低于完全扩张组和孵出组的临床妊娠率（6095%、6154%）和种植率（6095%、6154%），三组的流产率依次递减但无统计学差异分别为（1818%、1563%、1250%）。结论：Day 5囊胚较Day 6囊胚具有更好的发育潜能，解冻后可获得更好的妊娠结局；冻融后囊胚腔的扩张程度越好，其发育潜能越高，显著改善妊娠结局。 　　【关键词】冻融囊胚；玻璃化冷冻；单囊胚移植；种植率 　　Effect of frozen blastocysts period and the re-expansion degree of frozen-thawed blastocysts on pregnancy outcome in frozen-thawed single blastocyst transfer cycleJIANG Yiqun， WANG Shanshan， XU Zhipeng， ZHANG Ningyuan， SUN Haixiang△. Reproductive Medicine Center， Affiliated Drum Tower Hospital of Nanjing University Medical School， Nanjing 210008， Jiangsu， China 　　【Abstract】Objectives： To compare the implantation rate， pregnancy rate and miscarriage rate following transfer of frozen-thowed embryos on 5th day and 6th day， and to assess the predictive value of the re-expansion of the blastocoel in pregnancy outcome. Methods： This retrospective study was done among 211 patients received frozen-thawed single blastocyst transfer treatment in our productive center from October 2013 to October 2014. The patients were divided into 5th day group （n=113） and 6th day group （n=98）. The implantation rate， pregnancy rate and miscarriage rate were compared between the two groups. Also the patients were divided into three groups according the re-expansion of the blastocyst： partial expansion group （n=54）， complete expansion group （n=105）， hatch group （n=52）. The clinical pregnancy rate， implantation rate and the abortion rate among the three groups were compared. Results： The clinical pregnancy and implantation rate for single b