Sifer C, Sermondade N, Dupont C, Poncelet C, Cédrin-Durnerin I, Hugues J-N, Benzacken B, Levy R
Service d'histologie-embryologie-cytogénétique, pôle femme-et-enfant, CHU Jean-Verdier, Assistance Publique-Hôpitaux de Paris, avenue du 14-juillet, Bondy, France.
Gynecol Obstet Fertil. 2012 Mar;40(3):158-61. doi: 10.1016/j.gyobfe.2011.10.004. Epub 2011 Dec 7.
Since the end of 2010, France by "l'Agence de Biomédecine" has validated the embryo vitrification procedure as an improvement of the slow freezing method. We presented here data concerning biological and clinical outcomes from a prospective observational study where early cleavage stage good quality embryos were vitrified and warmed. We compared these results to those of a retrospective series where embryos were thawed after a slow freezing procedure (SF). We report also the first French live birth following embryo vitrification.
In all, 58 cycles of frozen-thawed embryo transfers (FET) following vitrification were prospectively included and compared with 189 FET from SF method. Primary end points were the (i) survival rate (SR) (% of embryos with ≥50% post-thaw intact blastomeres), (ii) intact survival rate (ISR) (% of embryos with 100% post-thaw intact blastomeres) and (iii) survival blastomeres index (SBI) (% of post thaw intact blastomeres per survival embryo). Secondary end point was the clinical pregnancy rate (CPR) defined as the presence of an intra-uterine gestational sac with positive foetal heart beat. We report here the first French live birth following embryo vitrification.
In all, 87 and 412 embryos have been thawed following vitrification and SF, respectively. We observed a highly significant increase of SR, ISR et SBI respectively when thawing concerned vitrified embryos rather than those from SF method (98.3±13.1% vs. 77.3±32.0%, P<10(-4); 88.2±28.3% vs. 47.7±41.4%, P<10(-4); 97.7±6.1% vs. 87.3±14.4%, P<10(-4)). Furthermore, CPR were of 32.7% (19/58) and of 18.5% (35/189) following FET performed after vitrification or SF and thawing (P=0.03), respectively. The live birth of two healthy girls occurred following a caesarean section after 38 weeks of amenorrhea the 8th of August 2011.
We experienced in our study that the post-thaw survival of vitrified embryos was significantly better than those of embryos resulting from SF. Then, a better CPR per thawed embryo cycle was observed following vitrification.
自2010年底起，法国生物医学局（“l'Agence de Biomédecine”）已批准胚胎玻璃化冷冻程序，将其作为慢速冷冻方法的一项改进。在此，我们展示了一项前瞻性观察研究中的生物学和临床结果数据，该研究对早期卵裂阶段的优质胚胎进行了玻璃化冷冻和复温处理。我们将这些结果与一项回顾性系列研究的结果进行了比较，该回顾性研究中胚胎采用慢速冷冻程序（SF）解冻。我们还报告了法国首例胚胎玻璃化冷冻后的活产情况。
总共前瞻性纳入了58个玻璃化冷冻后解冻胚胎移植（FET）周期，并与189个采用SF方法的FET周期进行比较。主要终点为：（i）存活率（SR）（解冻后完整卵裂球≥50%的胚胎百分比），（ii）完整存活率（ISR）（解冻后卵裂球100%完整的胚胎百分比），以及（iii）存活卵裂球指数（SBI）（每个存活胚胎解冻后完整卵裂球的百分比）。次要终点为临床妊娠率（CPR），定义为子宫内妊娠囊伴有阳性胎心搏动。我们在此报告法国首例胚胎玻璃化冷冻后的活产情况。
玻璃化冷冻和SF解冻后，分别有87个和412个胚胎解冻。当解冻的是玻璃化冷冻胚胎而非SF方法冷冻的胚胎时，我们观察到SR、ISR和SBI均显著提高（98.3±13.1%对77.3±32.0%，P<10⁻⁴；88.2±28.3%对47.7±41.4%，P<10⁻⁴；97.7±6.1%对87.3±14.4%，P<10⁻⁴）。此外，玻璃化冷冻或SF解冻后进行FET的CPR分别为32.7%（19/58）和18.5%（35/189）（P = 0.03）。2011年8月8日，在闭经38周后剖宫产分娩出两名健康女婴。
我们在研究中发现，玻璃化冷冻胚胎解冻后的存活率显著高于SF冷冻的胚胎。因此，玻璃化冷冻后每个解冻胚胎周期的CPR更高。
