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37℃全程解冻方法可改善玻璃化冷冻解冻胚胎移植的临床结局:一项采用病例对照匹配分析的回顾性研究

An all-37 °C thawing method improves the clinical outcomes of vitrified frozen-thawed embryo transfer: a retrospective study using a case-control matching analysis.

作者信息

Yan Gaofeng, Yao Youlin, Yang Wenjuan, Lu Ling, Wang Longda, Zhao Di, Zhao Shuhua

机构信息

Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China.

出版信息

Arch Gynecol Obstet. 2023 Jun;307(6):1991-1999. doi: 10.1007/s00404-023-07029-1. Epub 2023 Apr 12.

Abstract

PURPOSE

The purpose of this study is to assess the impact of different temperatures and incubation times on the clinical outcomes of FET cycles during the thawing procedure and to select a better thawing method to improve clinical outcomes.

METHODS

This retrospective study included 1734 FET cycles from January 1, 2020, to January 30, 2022. Embryos vitrified using a KITAZATO Vitrification Kit were thawed at 37 °C in all steps (the case group, denoted the "all-37 °C" group) or at 37 °C and then at room temperature (RT; the control group, denoted the "37 °C-RT" group), according to the kit instructions. The groups were matched 1:1 to avoid confounding.

RESULTS

After case-control matching, 366 all-37 °C cycles and 366 37 °C-RT cycles were included. The baseline characteristics were similar (all P > 0.05) between the two groups after matching. FET of the all-37 °C group yielded a higher clinical pregnancy rate (CPR; P = 0.009) and implantation rate (IR; P = 0.019) than FET of the 37 °C-RT group. For blastocyst transfers, the CPR (P = 0.019) and IR (P = 0.025) were significantly higher in the all-37 °C group than in the 37 °C-RT group. For D3-embryo transfers, the CPR and IR were non-significantly higher in the all-37 °C group than in the 37 °C-RT group (P > 0.05).

CONCLUSIONS

Thawing vitrified embryos at 37 °C in all steps with shortening wash time can enhance CPR and IR in FET cycles. Well-designed prospective studies are warranted to further evaluate the efficacy and safety of the all-37 °C thawing method.

摘要

目的

本研究旨在评估解冻过程中不同温度和孵育时间对冻融胚胎移植(FET)周期临床结局的影响,并选择一种更好的解冻方法以改善临床结局。

方法

这项回顾性研究纳入了2020年1月1日至2022年1月30日期间的1734个FET周期。根据试剂盒说明,使用北里玻璃化试剂盒玻璃化的胚胎在所有步骤中均于37°C解冻(病例组,称为“全37°C”组),或先于37°C解冻,然后于室温(RT)解冻(对照组,称为“37°C-RT”组)。两组进行1:1匹配以避免混杂因素。

结果

病例对照匹配后,纳入了366个全37°C周期和366个37°C-RT周期。匹配后两组的基线特征相似(所有P>0.05)。全37°C组的FET临床妊娠率(CPR;P=0.009)和着床率(IR;P=0.019)高于37°C-RT组的FET。对于囊胚移植,全37°C组的CPR(P=0.019)和IR(P=0.025)显著高于37°C-RT组。对于D3胚胎移植,全37°C组的CPR和IR略高于37°C-RT组,但差异无统计学意义(P>0.05)。

结论

在所有步骤中于37°C解冻玻璃化胚胎并缩短冲洗时间可提高FET周期的CPR和IR。有必要进行精心设计的确前瞻性研究,以进一步评估全37°C解冻方法的有效性和安全性。

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