Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, People's Republic of China.
Department of gynecology and obstetrics, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Int J Gynaecol Obstet. 2023 Mar;160(3):806-813. doi: 10.1002/ijgo.14355. Epub 2022 Aug 3.
To identify whether the transfer of blastocysts that have been vitrified, thawed, biopsied, revitrified, and subsequently rethawed affects clinical outcome and neonatal outcome.
A retrospective study was conducted in a single assisted reproduction technology center from September 2016 to March 2021. Women undergoing single frozen euploid blastocysts transfer were stratified into two groups based on number of vitrification-thawing cycles: single vitrification coupled with single biopsy (group A, n = 177) and double vitrification coupled with single biopsy (group B, n = 30). Pregnancy and perinatal outcomes of the two groups were compared.
Clinical pregnancy rates were similar between the two groups. Group B was associated with an increased likelihood of live birth when compared with group A by different multivariable analysis models (model 1: odds ratio, 0.42 [95% confidence interval, 0.18-0.97], P = 0.041; model 2: odds ratio, 0.38 [95% confidence interval, 0.16-0.92], P = 0.033). No major obstetrical complication was reported in the two groups and only one malformation live birth was reported in group A.
The procedure of double vitrification-warming cycles, coupled with single biopsy, increases pregnancy loss and ultimately diminishes live birth but does not affect perinatal outcome. Future studies with a larger sample size would help to validate the results.
确定冷冻、解冻、活检、复冻和随后再解冻的囊胚移植是否会影响临床结局和新生儿结局。
本研究为 2016 年 9 月至 2021 年 3 月在一家辅助生殖技术中心进行的回顾性研究。根据冻融周期数,将接受单枚整倍体冷冻囊胚移植的女性分为两组:单冻单活检组(A 组,n=177)和双冻单活检组(B 组,n=30)。比较两组的妊娠和围产儿结局。
两组的临床妊娠率相似。通过不同的多变量分析模型,B 组的活产率明显高于 A 组(模型 1:优势比,0.42[95%置信区间,0.18-0.97],P=0.041;模型 2:优势比,0.38[95%置信区间,0.16-0.92],P=0.033)。两组均未报告重大产科并发症,仅 A 组报告了 1 例畸形活产。
双冻融-复温循环联合单活检程序增加了流产风险,最终降低了活产率,但不影响围产儿结局。未来需要更大样本量的研究来验证这些结果。