扩张和疝出：在冷冻囊胚移植中进行四分之一激光辅助孵化后，评估最佳妊娠率预测指标。
Expansion and herniation: evaluation of the best pregnancy rate predictor after quarter laser assisted hatching in frozen blastocyst transfers.
机构信息
Instituto Idéia Fértil de Saúde Reprodutiva, Santo André, SP, Brazil.
出版信息
JBRA Assist Reprod. 2020 May 1;24(2):170-172. doi: 10.5935/1518-0557.20190090.
OBJECTIVE
To assess the recovery of thawed blastocysts submitted to quarter laser assisted hatching and examine potential correlations between the procedure and pregnancy rates.
METHODS
This cross-sectional study included only single-blastocyst transfers performed from July 2017 to December 2018. A total of 765 blastocysts were thawed and immediately submitted to quarter laser assisted hatching in the zona pellucida; they were subsequently incubated for three hours until transfer time, at which time they were examined for collapse or expansion; expanded blastocysts were further evaluated for herniation. The Chi-square test was used in statistical analysis.
RESULTS
627 blastocysts expanded (81.9%) and yielded a pregnancy rate of 40% (251/627). 138 blastocysts collapsed after thawing (18.0%) and yielded a pregnancy rate of 25.4% (35/138) (p=0.001). Additional analysis of the subgroup of expanded blastocysts revealed that the 385 herniated blastocysts (61.4%) yielded a pregnancy rate of 43.9% (169/385). The remaining 242 non-herniated blastocysts (38.6%) yielded a pregnancy rate of 33.9% (82/242) (p=0.013). Statistical significance was attributed to events with a p<0.05.
CONCLUSION
Quarter laser assisted hatching is a safe, valid, and relatively easy-to-use procedure for thawed blastocysts. Blastocysts that expanded and herniated after quarter laser assisted hatching presented statistically superior results.
目的
评估经四分之一激光辅助孵化解冻的囊胚的恢复情况，并研究该过程与妊娠率之间的潜在相关性。
方法
本横断面研究仅纳入 2017 年 7 月至 2018 年 12 月期间进行的单囊胚移植。共有 765 个囊胚解冻后立即在透明带进行四分之一激光辅助孵化；随后孵育 3 小时至移植时间，此时检查囊胚是否塌陷或扩张；扩张的囊胚进一步评估疝出情况。采用卡方检验进行统计学分析。
结果
627 个囊胚扩张（81.9%），妊娠率为 40%（251/627）。138 个囊胚解冻后塌陷（18.0%），妊娠率为 25.4%（35/138）（p=0.001）。对扩张囊胚的亚组进一步分析显示，385 个疝出囊胚（61.4%）的妊娠率为 43.9%（169/385）。其余 242 个非疝出囊胚（38.6%）的妊娠率为 33.9%（82/242）（p=0.013）。具有统计学意义的事件 p 值均小于 0.05。
结论
四分之一激光辅助孵化是一种安全、有效且相对易用的解冻囊胚方法。经四分之一激光辅助孵化后扩张和疝出的囊胚结果具有统计学优势。
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