Chongqing Health Center for Women and Children, Chongqing, People's Republic of China.
Chongqing Key Laboratory of Human Embryo Engineering, Chongqing, People's Republic of China.
Reprod Sci. 2022 Jun;29(6):1930-1938. doi: 10.1007/s43032-022-00880-8. Epub 2022 Feb 25.
It was suggested that the embryo pooling was an alternative for patients with insufficient number of embryos for preimplantation genetic testing (PGT) in a single ovarian stimulation cycle. However, limited study noticed whether it is an efficient strategy to pool cleavage-stage embryos by vitrification. This study included 71 cycles with vitrified-warmed and fresh embryos simultaneously for PGT between May 2016 and May 2021. The embryos from the same patients were split into two groups based on the origin: warming group and fresh group. Embryo development, sequencing results, clinical and neonatal outcomes were compared. The results showed that the rate of high-quality embryos in the warming group was significantly higher than that in the fresh group (64.53% versus 52.61%, P = 0.011); however, the available blastocyst rate in this group was significantly lower than that in the fresh group (47.29% versus 57.83%, P = 0.026). There were 96 and 144 blastocysts that underwent trophectoderm (TE) biopsy in warming and fresh groups, respectively. The high-quality blastocyst rate was significantly lower in the warming group compared to the fresh group (57.29% versus 70.14%, P = 0.041). The rates of genetic transferable blastocyst were comparable between the two groups (P = 0.956). There were no statistical differences in terms of embryo implantation, clinical pregnancy, miscarriage rates, and neonatal outcomes between the two groups. In conclusion, this study demonstrated that the cleavage-stage embryo pooling strategy might be unfavorable for the maintenance of embryonic development potential. If not necessary, it is not recommended to pool cleavage-stage embryos for PGT.
有人提出，在单个卵巢刺激周期中，对于胚胎数量不足进行胚胎植入前遗传学检测（PGT）的患者，胚胎pooling 是一种替代方案。然而，有限的研究注意到通过玻璃化冷冻来pooling 卵裂期胚胎是否是一种有效的策略。这项研究纳入了 2016 年 5 月至 2021 年 5 月间同时进行 PGT 的 71 个周期的冷冻解冻和新鲜胚胎。根据来源，将来自同一患者的胚胎分为两组：解冻组和新鲜组。比较了胚胎发育、测序结果、临床和新生儿结局。结果显示，解冻组的优质胚胎率显著高于新鲜组（64.53%比 52.61%，P=0.011）；然而，该组的可利用囊胚率显著低于新鲜组（47.29%比 57.83%，P=0.026）。解冻组和新鲜组分别有 96 个和 144 个囊胚进行滋养外胚层（TE）活检。解冻组的优质囊胚率显著低于新鲜组（57.29%比 70.14%，P=0.041）。两组的可遗传囊胚率无统计学差异（P=0.956）。两组的胚胎着床率、临床妊娠率、流产率和新生儿结局均无统计学差异。总之，本研究表明，卵裂期胚胎 pool 策略可能不利于维持胚胎发育潜能。如果没有必要，不建议为 PGT 进行卵裂期胚胎 pool。
