激光辅助孵化完全去除透明带对冷冻单囊胚移植结局的影响

doi:10.16150/j.1671-2870.2019.03.017

摘要/Abstract

摘要：

目的： 回顾分析激光辅助孵化完全去除透明带对冷冻单囊胚移植患者妊娠率及胚胎种植率等妊娠结局的影响。方法： 选取2016年9月到2018年8月在上海永远幸妇科医院进行单囊胚移植的患者,共200个周期,将其随机分为2组,研究组在移植前完全去除透明带,对照组在移植前部分削薄透明带。对2组患者的基本情况[年龄、体质量指数（body mass index, BMI）、不育原因、基础卵泡刺激素（follicle stimulating hormone, FSH水平等）、卵裂率、优质胚胎率、囊胚形成率、妊娠率、胚胎种植率、单卵双胎率以及流产率等指标进行观察比较。结果： 研究组与对照组间的年龄、BMI、不育原因等差异没有统计学意义（P>0.05）;2组间的卵裂率、优质胚胎率、囊胚形成率差异亦无统计学意义（P>0.05）;而研究组的临床妊娠率（62.24%）、胚胎种植率（63.27%）明显高于对照组（53.06%、59.18%）（P<0.05）;其单卵双胎率（1.64%）、流产率（6.56%）则显著低于对照组（11.54%、11.54%）（P<0.05）。结论： 冷冻囊胚移植前完全去除透明带,可以作为一个提高单囊胚移植成功率的有效方法。

关键词: 完全去除透明带, 激光辅助孵化, 冷冻单囊胚移植, 临床妊娠率, 胚胎种植率

Abstract:

Objective: To study the effect of laser-assisted hatching with complete removal of zona pellucida on pregnancy outcomes such as pregnancy rate and embryo implantation rate of frozen single blastocyst transfer. Methods: The cases of 200 cycles of single blastocyst transfer in Shanghai Towako hospital from September 2016 to August 2018 were enrolled and were divided into two groups randomly. Partially thinned zona pellucida was performed in the control group and complete removal of zona pellucida was performed in the study group. The general information of the patients including age, body mass index (BMI), cause of infertility, basic FSH level, etc, good quality embryo rate, cleavage rate, blastocyst formation rate, pregnancy rate, embryo implantation rate, monozygotic twins rate and abortion rate were observed and compared. Results: The age, BMI, cause of infertility in the study group were not significantly different from those of the control group (P>0.05). There were also no significant differences in good quality embryo rate, cleavage rate and blastocyst formation rate (P>0.05) between the two groups, and the pregnancy rate and embryo implantation rate in the study group were significantly higher than those in the control group (P<0.05), and the rates of monozygotic twins and abortion were significantly lower than those of the control group (P<0.05). Conclusions: Complete removal of zona pellucida before frozen blastocyst transfer can be an effective method to improve the success rate of single blastocyst transfer.

Key words: Complete removal of zona pellucida, Laser-assisted hatching, Frozen single blastocyst transfer, Clinical pregnancy rate, Embryo implantation rate

中图分类号:

R725.8

黄亚, 徐利, 葛凤菊, 吴鋆龙, 陈亚宁, 祁秀娟. 激光辅助孵化完全去除透明带对冷冻单囊胚移植结局的影响[J]. 诊断学理论与实践, 2019, 18(03): 334-339.

HUANG Ya, XU Li, GE Fengju, WU Yunlong, CHEN Yaning, QI Xiujuan. Effect of laser-assisted hatching with complete removal of zona pellucida on the outcome of frozen single blastocyst transfer[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(03): 334-339.

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组别	周期数	平均年龄（岁）	BMI(kg/m²)	FSH(IU/mL)	内膜厚度（mm）	不孕原因（周期）（n=98）
组别	周期数	平均年龄（岁）	BMI(kg/m²)	FSH(IU/mL)	内膜厚度（mm）	输卵管因素	男方因素	排卵障碍	双方因素
对照组	98	34.3±1.6	21.4±2.2	7.65±1.2	8.53±1.81	41	15	11	31
研究组	98	34.5±1.7	21.1±2.0	7.56±1.0	8.68±1.68	42	12	11	33
P值	/	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	周期数	卵裂率	优胚率	囊胚形成率
对照组	98	95.8	54.8	49.8
研究组	98	96.6	55.6	50.2
P值	/	>0.05	>0.05	>0.05

组别	临床妊娠率（%）	胚胎种植率（%）	单卵双胎率（%）	流产率（%）
对照组（周期数98个）	53.06（52/98）	59.18（58/98）	11.54（6/52）	11.54（6/52）
研究组（周期数98个）	62.24（61/98）	63.27（62/98）	1.64（1/61）	6.56（4/61）
P值	<0.05	<0.05	<0.01	<0.05