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由质量差的卵裂期胚胎冷冻解冻形成的囊胚,其流产率较高。

Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos.

机构信息

Reproductive Medical Center of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Endocrinol (Lausanne). 2020 Sep 16;11:561085. doi: 10.3389/fendo.2020.561085. eCollection 2020.

Abstract

Embryos with low morphological scores can still develop to the blastocyst stage and result in good clinical outcomes. However, no studies have reported the possible effects of transferring cryopreserved blastocysts developed from poor-quality cleavage stage embryos on pregnancy and perinatal outcomes. In this retrospective study, the clinical value of transferring blastocysts derived from day 3 poor-quality cleavage stage embryos during fertilization and embryo transfer procedures was evaluated. According to the quality of embryos on day 3 from which the transferred blastocyst originated, patients were divided into three groups: poor-quality (111 cycles, group A), good-quality (235 cycles, group B), and top-quality (119 cycles, group C). Group A experienced the highest miscarriage rate (30.2%) which was increased when compared to group C (12.5%) ( = 0.03). The clinical pregnancy rates and live birth rates were not significantly different among the three groups. However, good blastocyst originating from top day 3 embryos resulted in higher live birth rate. Of the 218 live births, no differences in obstetric and perinatal outcomes were noted among the three groups. The results showed that extended culture of poor-quality cleavage stage embryos could resulted in favorable clinical pregnancy rates but at a higher incidence of miscarriages. Meanwhile, the risk of adverse perinatal outcomes was not increased.

摘要

胚胎形态评分低仍可发育至囊胚阶段,从而获得良好的临床结局。然而,尚无研究报道从质量差的卵裂期胚胎中冷冻保存的囊胚移植对妊娠和围产结局的可能影响。在这项回顾性研究中,评估了受精和胚胎移植过程中移植来自第 3 天质量差的卵裂期胚胎发育而来的囊胚的临床价值。根据转移囊胚来源的第 3 天胚胎的质量,将患者分为三组:质量差(111 个周期,A 组)、质量好(235 个周期,B 组)和质量最优(119 个周期,C 组)。A 组的流产率最高(30.2%),与 C 组(12.5%)相比有所增加(=0.03)。三组的临床妊娠率和活产率无显著差异。然而,优质囊胚来源于优质第 3 天胚胎,活产率更高。在 218 例活产儿中,三组间在产科和围产儿结局方面无差异。结果表明,延长培养质量差的卵裂期胚胎可获得良好的临床妊娠率,但流产率更高。同时,不良围产儿结局的风险并未增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e13/7525122/8a05c74f9a28/fendo-11-561085-g0001.jpg

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