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在新鲜卵裂期胚胎移植前消除胚胎碎片后的临床妊娠

Clinical Pregnancy After Elimination of Embryo Fragments Before Fresh Cleavage-stage Embryo Transfer.

作者信息

Sordia-Hernandez Luis H, Morales-Martinez Felipe A, Frazer-Moreira Lorna M, Villarreal-Pineda Lilith, Sordia-Piñeyro María Ofelia, Valdez-Martinez Otto H

机构信息

Department of Gynecology and Obstetrics, Dr. Jose Eleuterio Gonzalez Hospital, School of Medicine, Nuevo Leon Free University, Monterrey, Mexico.

出版信息

J Family Reprod Health. 2020 Sep;14(3):198-204. doi: 10.18502/jfrh.v14i3.4674.

Abstract

To determine if the elimination of fragments in cleavage-stage embryos, before fresh transfer, improves pregnancy rates in fertilization cycles. This is a Prospective observational case-control study carried out at a University Reproductive Center. We included Twenty-six infertile patients divided into two groups. Group one: 13 patients with embryos classified as grade B and C (embryos with fragments) according to the Hill classification, and Group two: 13 patients with grade A embryos (embryos with no fragments). Embryo Defragmentation was performed in embryos of group one 65 to 68 hours after conventional fertilization. Fresh embryo transfer was made after two hours post fragments removal. Reproductive results were evaluated and compared between both groups. The total number of clinical pregnancies was nine. In group one there were 5 (38.5 %); in group two, there were 4 (30.8%). The difference was not statistically significant ( = 0.68). Two abortions were reported in the study, both in group one; were fragment elimination was performed. This represents an abortion rate of 40% in patients who got pregnant in this group. These patients had twice the probability of suffering an abortion (OR 2.1; 95% CI 1.4-3.37). Ongoing pregnancies were similar in both groups. Removal of fragments in freshly transferred day three embryos could be an alternative to increase clinical pregnancy and ongoing pregnancy rates in patients who have only poor-quality embryos. Despite the relationship with a higher abortion rate, this strategy could represent a real alternative for this type of patient.

摘要

为确定在新鲜胚胎移植前去除卵裂期胚胎中的碎片是否能提高受精周期的妊娠率。这是一项在大学生殖中心进行的前瞻性观察性病例对照研究。我们纳入了26名不孕患者,分为两组。第一组:13名根据希尔分类法胚胎被归类为B级和C级(有碎片的胚胎)的患者,第二组:13名胚胎为A级(无碎片的胚胎)的患者。在常规受精后65至68小时对第一组的胚胎进行胚胎碎片去除。在去除碎片两小时后进行新鲜胚胎移植。对两组的生殖结果进行评估和比较。临床妊娠总数为9例。第一组有5例(38.5%);第二组有4例(30.8%)。差异无统计学意义(P = 0.68)。研究中报告了2例流产,均在第一组;即进行了碎片去除的组。这代表该组怀孕患者的流产率为40%。这些患者流产的可能性是正常情况的两倍(比值比2.1;95%置信区间1.4 - 3.37)。两组的持续妊娠情况相似。对于仅有质量较差胚胎的患者,在新鲜移植的第三天胚胎中去除碎片可能是提高临床妊娠率和持续妊娠率的一种选择。尽管与较高的流产率有关,但这种策略可能是这类患者的一种切实可行的选择。

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