冻融后延迟和/或不完全致密的多余桑葚胚的发育潜力。
Developmental potential of surplus morulas with delayed and/or incomplete compaction after freezing-thawing procedures.
机构信息
Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung city, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
出版信息
Reprod Biol Endocrinol. 2019 Oct 30;17(1):87. doi: 10.1186/s12958-019-0535-2.
BACKGROUND
Morulas with delayed growth sometimes coexist with blastocysts. There is still limited evidence regarding the optimal disposal of surplus morulas. With the advancement of vitrification, the freezing-thawing technique has been widely applied to zygotes with 2 pronuclei, as well as embryos at the cleavage and blastocyst stages. The freezing of morulas, however, has rarely been discussed. The purpose of this study was to investigate whether these poor-quality and slow-growing morulas are worthy of cryopreservation.
METHODS
This is a retrospective, observational, proof-of-concept study. A total of 1033 day 5/6 surplus morulas were cryopreserved from January 2015 to December 2018. The study included 167 women undergoing 180 frozen embryo transfer cycles. After the morulas underwent freezing-thawing procedures, their development was monitored for an additional day. The primary outcome was the blastocyst formation rate. Secondary outcomes were clinical pregnancy rate, live birth rate and abortion rate.
RESULTS
A total of 347 surplus morulas were thawed. All studied morulas showed delayed compaction (day 5, n = 329; day 6, n = 18) and were graded as having low (M1, n = 54), medium (M2, n = 138) or high (M3, n = 155) fragmentation. The post-thaw survival rate was 79.3%. After 1 day in extended culture, the blastocyst formation rate was 66.6%, and the top-quality blastocyst formation rate was 23.6%. The day 5 morulas graded as M1, M2, and M3 had blastocyst formation rates of 88.9, 74.0, and 52.8% (p < 0.001), respectively, and the top-quality blastocyst formation rates were 64.8, 25.2, and 9.0% (p < 0.001), respectively. The clinical pregnancy rate was 33.6%.
CONCLUSIONS
The post-thaw blastocyst formation rate was satisfactory, with approximately one-half of heavily fragmented morulas (M3) developing into blastocysts. Most of the poor-quality morulas were worth to freeze, with the reasonable goal of obtaining pregnancy and live birth. This alternative strategy may be a feasible approach for coping with poor-quality surplus morulas in non-PGS (preimplantation genetic screening) cycles.
背景
发育迟缓的桑椹胚有时与囊胚共存。对于多余桑椹胚的最佳处理方法，仍缺乏有限的证据。随着玻璃化技术的进步，冷冻-解冻技术已广泛应用于具有 2 个原核的受精卵以及卵裂期和囊胚期胚胎。然而，桑椹胚的冷冻保存却很少被讨论。本研究旨在探讨这些质量差、生长缓慢的桑椹胚是否值得冷冻保存。
方法
这是一项回顾性、观察性、概念验证研究。2015 年 1 月至 2018 年 12 月，共有 1033 枚第 5/6 天的多余桑椹胚进行了冷冻保存。该研究纳入了 167 名接受 180 个冷冻胚胎移植周期的妇女。桑椹胚冷冻解冻后，再额外培养一天，监测其发育情况。主要结局是囊胚形成率。次要结局是临床妊娠率、活产率和流产率。
结果
共解冻了 347 枚多余桑椹胚。所有研究的桑椹胚均表现出明显的迟发性致密化（第 5 天，n=329；第 6 天，n=18），且均为低碎片（M1，n=54）、中碎片（M2，n=138）或高碎片（M3，n=155）。解冻后的存活率为 79.3%。在延长培养 1 天后，囊胚形成率为 66.6%，优质囊胚形成率为 23.6%。第 5 天的 M1、M2 和 M3 级桑椹胚的囊胚形成率分别为 88.9%、74.0%和 52.8%（p<0.001），优质囊胚形成率分别为 64.8%、25.2%和 9.0%（p<0.001）。临床妊娠率为 33.6%。
结论
解冻后的囊胚形成率令人满意，约一半碎片严重的桑椹胚（M3）发育为囊胚。大多数质量差的桑椹胚值得冷冻保存，合理的目标是获得妊娠和活产。对于非 PGS（植入前遗传学筛查）周期中的质量差的多余桑椹胚，这种替代策略可能是一种可行的方法。
Zotero 插件