Department of General Surgery and Medical Surgical Specialties, University of Catania, Via Santa Sofia 78, 95125, Catania, Italy.
Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090, Brussels, Belgium.
J Assist Reprod Genet. 2022 Sep;39(9):2069-2075. doi: 10.1007/s10815-022-02572-3. Epub 2022 Jul 20.
Does cell loss (CL) after vitrification and warming (V/W) of day 3 embryos have an impact on live birth rate (LBR) and neonatal outcomes?
This retrospective analysis includes cleavage stage day 3 embryos vitrified/warmed between 2011 and 2018. Only single vitrified/warmed embryo transfers were included. Pre-implantation genetic screening, oocyte donation, and age banking were excluded from the analysis. The sample was divided into two groups: group A (intact embryo after warming) and group B (≤ 50% blastomere loss after warming).
On the total embryos (n = 2327), 1953 were fully intact (83.9%, group A) and 374 presented cell damage (16.1%, group B). In group B, 62% (232/374) of the embryos had lost only one cell. Age at cryopreservation, cause of infertility, insemination procedure, and semen origin were comparable between the two groups. The positive hCG rate (30% and 24.3%, respectively, for intact vs CL group, p = 0.028) and LBR (13.7% and 9.4%, respectively, for intact vs CL group, p = 0.023) per warming cycle were significantly higher for intact embryos. However, LBR per positive hCG was equivalent between intact and damaged embryos (45.6% vs 38.5%, respectively, p = 0.2). Newborn measurements (length, weight, and head circumference at birth) were comparable between the two groups. Multivariate logistic regression showed that the presence of CL is not predictive for LB when adjusting for patients' age.
LBR is significantly higher after transfer of an intact embryo compared to an embryo with CL after warming; however, neonatal outcomes are comparable between the two groups.
第三天胚胎玻璃化冷冻及复苏后细胞丢失（CL）是否会影响活产率（LBR）和新生儿结局？
本回顾性分析纳入了 2011 年至 2018 年期间玻璃化冷冻/复苏的第三天卵裂期胚胎。仅纳入了单个玻璃化冷冻/复苏胚胎移植。本分析排除了胚胎植入前遗传学筛查、卵母细胞捐赠和年龄储存。样本被分为两组：A 组（复苏后胚胎完整）和 B 组（复苏后胚胎碎裂＜50%）。
在总共 2327 个胚胎中，1953 个胚胎完整（83.9%，A 组），374 个胚胎有细胞损伤（16.1%，B 组）。在 B 组中，62%（232/374）的胚胎仅丢失了一个细胞。两组间冷冻时的年龄、不孕原因、授精方式和精液来源相似。每个复苏周期的 hCG 阳性率（完整组为 30%，CL 组为 24.3%，p=0.028）和活产率（完整组为 13.7%，CL 组为 9.4%，p=0.023）均显著更高。然而，每个 hCG 阳性周期的活产率在完整胚胎和受损胚胎之间是等效的（分别为 45.6%和 38.5%，p=0.2）。两组新生儿的测量指标（出生时的身长、体重和头围）相似。多变量逻辑回归显示，在调整患者年龄后，CL 的存在并不能预测 LB。
与复苏后有 CL 的胚胎相比，完整胚胎的移植活产率显著更高；然而，两组的新生儿结局相似。
