Wirleitner B, Schuff M, Stecher A, Murtinger M, Vanderzwalmen P
IVF Centers Prof. Zech - Bregenz, Römerstrasse 2, A-6900 Bregenz, Austria
IVF Centers Prof. Zech - Bregenz, Römerstrasse 2, A-6900 Bregenz, Austria.
Hum Reprod. 2016 Aug;31(8):1685-95. doi: 10.1093/humrep/dew127. Epub 2016 Jun 6.
How do live birth rates (LBRs), following fresh and vitrified/warmed embryo transfer, compare according to morphological grade, developmental stage and culturing strategy of human blastocysts in vitro?
Equivalent LBRs were obtained after fresh embryo transfer and after vitrified/warmed embryo transfer of blastocysts of top or non-top quality, while vitrification after prolonged embryo culture of blastocysts with delayed development had a positive impact on LBR.
Blastocyst morphology correlates with clinical outcome; however, few data are available on vitrified/warmed embryo transfer using non-top quality blastocysts. The aim of this study was to determine clinical outcomes of non-top quality blastocysts and blastocysts with delayed development that underwent vitrified/warmed embryo transfer.
STUDY DESIGN, SIZE, DURATION: This retrospective, single-centre study (conducted January 2009 to June 2013) compared 1010 fresh embryo transfer and 1270 vitrified/warmed embryo transfer of blastocysts originating from the same stimulation cycle. Furthermore, 636 fresh embryo transfers and 304 vitrified/warmed embryo transfer after delayed expansion or blastulation in the same period were also analysed.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Clinical outcomes after fresh and vitrified/warmed embryo transfer according to blastocyst morphology were compared in both groups.
Similar LBRs after fresh embryo transfer or after vitrified/warmed embryo transfer of top or non-top quality blastocysts were observed. A statistically significant improvement in clinical outcomes was obtained after vitrified/warmed embryo transfer of Day 5 embryos with delayed expansion or blastulation when applying prolonged culture. Our study suggests that vitrification of non-top quality blastocysts as well as delayed cavitating and blastulating Day 5 embryos should be considered in autologous IVF cycles.
Given that the present retrospective study used aseptic vitrification of blastocysts, the results, particularly the survival rates, may not be fully applicable to other vitrification protocols. The retrospective nature of the study has to be mentioned.
Restriction of vitrification to top quality blastocysts may result in discarding potentially viable embryos.
This study was not externally funded. There are no conflicts of interest to declare.
根据人类囊胚的形态学等级、发育阶段和体外培养策略，新鲜胚胎移植和玻璃化/解冻胚胎移植后的活产率（LBRs）如何比较？
优质或非优质囊胚新鲜胚胎移植和玻璃化/解冻胚胎移植后获得了相当的活产率，而发育延迟的囊胚延长胚胎培养后进行玻璃化对活产率有积极影响。
囊胚形态与临床结局相关；然而，关于使用非优质囊胚进行玻璃化/解冻胚胎移植的数据很少。本研究的目的是确定接受玻璃化/解冻胚胎移植的非优质囊胚和发育延迟的囊胚的临床结局。
研究设计、规模、持续时间：这项回顾性单中心研究（于2009年1月至2013年6月进行）比较了来自同一刺激周期的1010例新鲜胚胎移植和1270例囊胚玻璃化/解冻胚胎移植。此外，还分析了同期636例新鲜胚胎移植和304例延迟扩张或囊胚形成后的玻璃化/解冻胚胎移植。
参与者/材料、设置、方法：比较了两组中根据囊胚形态的新鲜胚胎移植和玻璃化/解冻胚胎移植后的临床结局。
观察到优质或非优质囊胚新鲜胚胎移植或玻璃化/解冻胚胎移植后活产率相似。当应用延长培养时，发育延迟的第5天胚胎玻璃化/解冻胚胎移植后临床结局有统计学意义的改善。我们的研究表明，在自体体外受精周期中应考虑对非优质囊胚以及延迟形成囊腔和囊胚的第5天胚胎进行玻璃化。
鉴于本回顾性研究使用了囊胚的无菌玻璃化，结果，尤其是存活率，可能不完全适用于其他玻璃化方案。必须提及研究的回顾性性质。
将玻璃化限制在优质囊胚可能导致丢弃潜在可行的胚胎。
本研究没有外部资金。没有利益冲突需要声明。
