Zhu Haiyan, Xu Wen, Jin Xiaoying, Xue Yamei, Tong Xiaomei, Zhang Songying
Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, China.
Medicine (Baltimore). 2020 Aug 14;99(33):e21660. doi: 10.1097/MD.0000000000021660.
This study aimed to investigate the effect of the duration of embryo culture on clinical outcome in vitrified-warmed cycles.This retrospective cohort study enrolled 10,464 infertile patients, with a total of 18,843 vitrified-warmed day 3 embryos from 2012 to 2017 at a single center. The patients were divided into 2 groups: 9470 cycles in the short-term culture group (0.5-8 hours of post-thaw culture) and 994 cycles in the 48 to 72 hours culture group. The independent effect of the following variables on clinical outcomes was determined: duration of post-thaw culture, maternal age, transferred embryos, embryo quality, and endometrial thickness.We found that the pregnancy rate was positively associated with the post-thaw culture time. Ordinary least square regression analyses showed that the duration of post-thaw culture was positively associated with implantation and live birth rates overall. However, the implantation and live birth rates were not significantly associated with the post-thaw culture time in the short-term culture group. Additionally, maternal age and the number of transferred embryos were independent predictors of the implantation and live birth rates. Moreover, the duration of post-thaw culture did not affect live birth weight.These results indicated that the pregnancy rate is positively associated with the duration of post-thaw culture. Therefore, under the condition of not affecting work shifts, properly prolonging the duration of post-thaw culture to improve the outcome of frozen-thawed embryo transfer should be considered.
本研究旨在探讨胚胎培养时长对玻璃化冷冻复苏周期临床结局的影响。这项回顾性队列研究纳入了10464例不孕患者，2012年至2017年在单一中心共有18843枚玻璃化冷冻的第三天胚胎。患者被分为两组：短期培养组（解冻后培养0.5 - 8小时）9470个周期，48至72小时培养组994个周期。确定了以下变量对临床结局的独立影响：解冻后培养时长、母亲年龄、移植胚胎数、胚胎质量和子宫内膜厚度。我们发现妊娠率与解冻后培养时间呈正相关。普通最小二乘回归分析表明，解冻后培养时长总体上与着床率和活产率呈正相关。然而，在短期培养组中，着床率和活产率与解冻后培养时间无显著相关性。此外，母亲年龄和移植胚胎数是着床率和活产率的独立预测因素。而且，解冻后培养时长不影响出生体重。这些结果表明妊娠率与解冻后培养时长呈正相关。因此，在不影响工作班次的情况下，应考虑适当延长解冻后培养时长以改善冻融胚胎移植的结局。
