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玻璃化冷冻囊胚移植后的产科结局。

Obstetric outcomes after transfer of vitrified blastocysts.

机构信息

Fertility Centre Scandinavia, Box 5418, SE-402 29 Göteborg, Sweden.

出版信息

Hum Reprod. 2010 Jul;25(7):1699-707. doi: 10.1093/humrep/deq117. Epub 2010 May 15.

Abstract

BACKGROUND

It has been claimed that the risks to the child resulting from vitrification as compared with the slow-freezing technique, may be higher owing to the high concentrations of potentially toxic cryoprotectants. We therefore retrospectively compared the obstetric and neonatal outcomes in a cohort of children born after transfer of vitrified blastocysts, fresh blastocysts and slow-frozen early cleavage stage embryos.

METHODS

All children born after transfer of vitrified blastocysts (n = 106), fresh blastocysts (n = 207) and slow-frozen early cleavage stage embryos (n = 206) during the period January 2006 to May 2008 at Fertility Center Scandinavia were included. Data on obstetric and neonatal outcomes were obtained from medical records from the antenatal and delivery clinics.

RESULTS

For singletons, there were no significant differences between the groups in gestational age, mortality or birth defects. After adjustment for parity and BMI, birthweight was significantly higher in singletons born after transfer of vitrified blastocysts as compared with after transfer of fresh blastocysts (median 3560 versus 3510 g, P = 0.0311). More singletons born after transfer of fresh blastocysts were small for gestational age compared with singletons born after transfer of vitrified blastocysts (12.1 versus 3.0%, P = 0.0085). A higher rate of major post-partum haemorrhage was observed in the vitrified blastocyst group as compared with the other two groups (25.0 versus 6.0 and 7.5%).

CONCLUSIONS

No adverse neonatal outcomes were observed in children born after transfer of vitrified, as compared with fresh blastocysts or after transfer of slow-frozen early cleavage stage embryos.

摘要

背景

有人声称,与慢速冻技术相比,玻璃化过程中由于潜在毒性的冷冻保护剂浓度较高,对儿童造成的风险可能更高。因此,我们回顾性比较了接受玻璃化囊胚、新鲜囊胚和慢速冻早期卵裂期胚胎移植后出生的一组儿童的产科和新生儿结局。

方法

在 2006 年 1 月至 2008 年 5 月期间,在斯堪的纳维亚生育中心接受玻璃化囊胚(n=106)、新鲜囊胚(n=207)和慢速冻早期卵裂期胚胎(n=206)移植后出生的所有儿童均纳入研究。产科和新生儿结局的数据来自产前和分娩诊所的病历。

结果

对于单胎,各组之间在胎龄、死亡率或出生缺陷方面没有显著差异。调整了产次和 BMI 后,玻璃化囊胚移植后出生的单胎体重明显高于新鲜囊胚移植后出生的单胎(中位数分别为 3560g 和 3510g,P=0.0311)。与玻璃化囊胚移植后出生的单胎相比,新鲜囊胚移植后出生的单胎中,小于胎龄儿的比例更高(12.1%比 3.0%,P=0.0085)。玻璃化囊胚组产后大出血的发生率明显高于其他两组(25.0%比 6.0%和 7.5%)。

结论

与新鲜囊胚或慢速冻早期卵裂期胚胎移植后出生的儿童相比,玻璃化囊胚移植后出生的儿童没有不良的新生儿结局。

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