Shu Yimin, Watt Jill, Gebhardt Janice, Dasig Jennifer, Appling Julie, Behr Barry
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California 94304, USA.
Fertil Steril. 2009 Feb;91(2):401-6. doi: 10.1016/j.fertnstert.2007.11.083. Epub 2008 Mar 4.
To investigate the role of fast blastocoele re-expansion in the selection of viable thawed blastocysts for transfer.
Retrospective study.
Academic assisted reproductive program.
PATIENT(S): Transfer cycles were divided into two groups according to the presence or absence of fast re-expanded blastocysts. In group I (124 cycles), all transferred blastocysts had fast re-expanding blastocoele. In group II (113 cycles), no fast re-expanded blastocysts were included in the transfer.
INTERVENTION(S): Blastocyst survival was defined as >50% of cells remaining intact after thaw and re-expansion after culture in vitro for 2-4 hours before transfer. Blastocysts with >or=50% re-expansion were designated as fast re-expanded blastocysts.
MAIN OUTCOME MEASURE(S): Percentage of blastomere loss immediately after thaw, degree of blastocoele re-expansion, and clinical outcomes (pregnancy and implantation rates).
RESULT(S): The rates of survival and fast blastocoele re-expansion of partially intact blastocysts were significantly reduced as compared with fully intact blastocysts. Significantly higher rates of clinical pregnancy (37.1% vs. 16.8%) and implantation (26.7% vs. 11.3%) were obtained when all transferred blastocysts had fast re-expanding blastocoele as compared with those transfers without fast re-expanded blastocysts included.
CONCLUSION(S): Our results showed that blastomere loss of thawed blastocyst was associated with a reduced ability to re-expand. As a discriminative morphologic marker of superior embryo viability, a fast re-expanded blastocyst would be given priority for transfer to better utilize the cryopreserved blastocysts.
探讨快速囊胚腔再扩张在选择可存活的解冻囊胚进行移植中的作用。
回顾性研究。
学术性辅助生殖项目。
根据是否存在快速再扩张的囊胚，将移植周期分为两组。第一组（124个周期），所有移植的囊胚均有快速再扩张的囊胚腔。第二组（113个周期），移植的囊胚中不包括快速再扩张的囊胚。
囊胚存活定义为解冻后细胞完整性保留>50%，并在移植前体外培养2 - 4小时后再扩张。再扩张率≥50%的囊胚被指定为快速再扩张囊胚。
解冻后立即出现的卵裂球丢失百分比、囊胚腔再扩张程度以及临床结局（妊娠率和着床率）。
与完全完整的囊胚相比，部分完整囊胚的存活率和快速囊胚腔再扩张率显著降低。与未包含快速再扩张囊胚的移植相比，当所有移植的囊胚均有快速再扩张的囊胚腔时，临床妊娠率（37.1%对16.8%）和着床率（26.7%对11.3%）显著更高。
我们的结果表明，解冻囊胚的卵裂球丢失与再扩张能力降低有关。作为优质胚胎活力的鉴别形态学标志物，快速再扩张的囊胚在移植时应优先考虑，以更好地利用冷冻保存的囊胚。
