Wang Caizhu, Feng Guixue, Zhang Bo, Zhou Hong, Shu Jinhui, Lin Ruoyun, Chen Huanhua, Wu Zhulian
Center of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi, 530003, China.
Reprod Biol Endocrinol. 2017 Apr 26;15(1):32. doi: 10.1186/s12958-017-0252-7.
In recent years, single blastocyst transfer combined with vitrification has been applied widely, which can maximize the cumulative pregnancy rate in per oocyte retrieval cycles and minimize the multiple pregnancy rate. Thus, the guarantee for these is the effectiveness of vitrified blastocyst. Studies has shown that AS of the blastocoel cavity prior to vitrification can reduce injuries, increase the thawed blastocyst survival rate and implantation rate. Several AS methods have been established. However, only a few studies have compared the effectiveness and safety of these AS methods. In this study, we aimed to compare the clinical outcomes and neonatal outcomes in FET cycles with single blastocyst that were artificially shrunk before vitrification by either LAS or MNAS method.
A retrospective comparative study of FET cycles in infertile patients which were at our clinic between January 2013 and December 2014. These FET cycles were divided into two groups by the shrinking methods used before vitrification and the clinical and neonatal outcomes were assessed.
There were no statistically differences in blastocyst survival rates (95.40% vs 94.05%, P > 0.05) between the LAS and MNAS groups. However, compared with MNAS, LAS improved the warmed blastocyst implantation/clinical pregnancy rate (60.82% vs 54.37%, P < 0.05), live birth rate (50.43% vs 45.22%, P < 0.05) and also increased the monozygotic twin rate (4.07% vs 1.73%, P < 0.05). There were no differences in the average gestational weeks (38.83 ± 1.57 vs 38.74 ± 1.75), premature birth rate (0.30% vs 0.49%), average birth weight (3217.89 ± 489.98 g vs 3150.88 ± 524.03 g), low birth weight rate (5.60% vs 8.63%) and malformation rate (0.59% vs 0.48%) (P > 0.05).
No significant differences in neonatal outcomes were observed, while in clinical outcomes, LAS improved the warmed blastocyst implantation/clinical pregnancy rate and live birth rate markedly, there was also an increased risk of monozygotic twin pregnancies.
近年来，单囊胚移植联合玻璃化冷冻技术已被广泛应用，该技术可使每个取卵周期的累积妊娠率最大化，并使多胎妊娠率最小化。因此，这些的保障是玻璃化冷冻囊胚的有效性。研究表明，在玻璃化冷冻前对囊胚腔进行人工塌陷可减少损伤，提高解冻后囊胚的存活率和着床率。已经建立了几种人工塌陷方法。然而，只有少数研究比较了这些人工塌陷方法的有效性和安全性。在本研究中，我们旨在比较在玻璃化冷冻前通过激光辅助塌陷（LAS）或微针辅助塌陷（MNAS）方法人工缩小的单囊胚冻融胚胎移植（FET）周期的临床结局和新生儿结局。
对2013年1月至2014年12月在我院就诊的不孕患者的FET周期进行回顾性比较研究。根据玻璃化冷冻前使用的塌陷方法将这些FET周期分为两组，并评估临床和新生儿结局。
LAS组和MNAS组之间的囊胚存活率无统计学差异（95.40%对94.05%，P>0.05）。然而，与MNAS相比，LAS提高了解冻后囊胚的着床/临床妊娠率（60.82%对54.37%，P<0.05）、活产率（50.43%对45.22%，P<0.05），并且单卵双胎率也有所增加（4.07%对1.73%，P<0.05）。平均孕周（38.83±1.57对38.74±1.75）、早产率（0.30%对0.49%）、平均出生体重（3217.89±489.98g对3150.88±524.03g）、低出生体重率（5.60%对8.63%）和畸形率（0.59%对0.48%）无差异（P>0.05）。
未观察到新生儿结局有显著差异，而在临床结局方面，LAS显著提高了解冻后囊胚的着床/临床妊娠率和活产率，但单卵双胎妊娠的风险也有所增加。
