Tucker M, Elsner C, Kort H, Massey J, Mitchell-Leef D, Toledo A
Reproductive Biology Associates, Atlanta, Georgia 30342.
Fertil Steril. 1991 Dec;56(6):1111-6. doi: 10.1016/s0015-0282(16)54725-6.
To investigate whether a poor rate of implantation after in vitro fertilization (IVF) was due to poor embryonic/endometrial synchrony during the original IVF cycle, we have cryopreserved reinseminated-fertilized embryos for later more synchronous replacement after thawing. The chance of implantation of fresh reinseminated fertilized human oocytes is approximately one tenth that of timely fertilized embryos. STUDY DESIGN AND DATA: Retrospective study of 35 original oocyte collections in which initial normal fertilization was 47.3% (129/273 oocytes), with 49.6% fertilization (67/135) upon reinsemination. Of these, 70 initially fertilized and 67 reinsemination-fertilized embryos were cryopreserved, and 50 initially fertilized and all 67 reinsemination-fertilized embryos were subsequently thawed with 72% and 63% cryosurvival, respectively, (not significant).
Private infertility clinic.
In 11 cycles, 23 thawed initially fertilized embryos (group A) were replaced with a 21.7% implantation rate per embryo; in 10 cycles, 13 initially fertilized and 12 reinsemination-fertilized embryos (group B) were replaced together with an 8% implantation rate; finally, in 16 cycles, 30 reinsemination-fertilized embryos (group C) were replaced with a 3.3% implantation rate (group A versus group C: P = 0.076). Comparison of clinical pregnancies between these groups was significantly different (6/11 versus 1/16; P = 0.0427).
Reinsemination-fertilized embryos survive freezing as well as initially fertilized embryos, but better embryonic/endometrial synchrony does not improve chances of their implantation.
为研究体外受精（IVF）后着床率低是否是由于初次IVF周期中胚胎/子宫内膜不同步，我们将再次受精的胚胎进行冷冻保存，以便在解冻后进行更同步的移植。新鲜的再次受精的人类卵母细胞着床的几率约为及时受精胚胎的十分之一。
对35例初次卵母细胞采集进行回顾性研究，其中初次正常受精率为47.3%（129/273个卵母细胞），再次受精时受精率为49.6%（67/135）。其中，70个初次受精胚胎和67个再次受精胚胎被冷冻保存，随后50个初次受精胚胎和所有67个再次受精胚胎被解冻，冷冻存活率分别为72%和63%（无显著差异）。
私立不孕诊所。
在11个周期中，移植了23个解冻的初次受精胚胎（A组），每个胚胎的着床率为21.7%；在10个周期中，一起移植了13个初次受精胚胎和12个再次受精胚胎（B组），着床率为8%；最后，在16个周期中，移植了30个再次受精胚胎（C组），着床率为3.3%（A组与C组比较：P = 0.076）。这些组之间临床妊娠的比较有显著差异（6/11对1/16；P = 0.0427）。
再次受精胚胎与初次受精胚胎一样能在冷冻后存活，但更好的胚胎/子宫内膜同步性并不能提高其着床几率。
