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玻璃化冷冻复苏单囊胚移植周期中一步法与序贯培养体系培养胚胎的产科和围产结局。

Obstetric and perinatal outcomes after embryos cultured in one-step versus sequential culture media systems in vitrified-warmed single blastocyst transfer cycles.

机构信息

Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China.

Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China.

出版信息

Reprod Biomed Online. 2023 Sep;47(3):103227. doi: 10.1016/j.rbmo.2023.04.018. Epub 2023 May 4.

DOI:10.1016/j.rbmo.2023.04.018
PMID:37270369
Abstract

RESEARCH QUESTION

Does type of culture medium used influence obstetric and perinatal outcomes after vitrified-warmed single blastocyst transfers?

DESIGN

Retrospective cohort study involving singletons after vitrified-warmed single blastocyst embryo transfers, using embryos cultured in either Irvine Continuous Single Culture medium (CSC) or Vitrolife G5 PLUS medium culture system between 2013 and 2020.

RESULTS

A total of 2475 women who had singleton deliveries were included for final analysis: 1478 had embryos cultured in CSC and 997 had embryos cultured in G5 PLUS medium. Birth outcomes, including preterm birth, mean birth weight, gestational age- and sex-adjusted birth weight (Z-scores), rates of large-for-gestational-age, small-for-gestational-age, low birth weight and macrosomia, and the distribution of newborn gender did not differ significantly between groups in crude and adjusted analyses. Women whose embryos were cultured in G5 PLUS frequently suffered from pregnancy-induced hypertensive disorders compared with those who had embryos cultured in CSC (4.7% versus 3.0%; P = 0.031). This difference was no longer significant after adjusting for several key confounders (adjusted odds ratio 1.49, 95% CI 0.94 to 2.38, P = 0.087). Other obstetric complications, including gestational diabetes mellitus, preterm premature rupture of membranes, abnormal placentation, postpartum haemorrhage and the mode of delivery were all similar between the two groups.

CONCLUSIONS

The present study adds new information to the current evidence by suggesting that the embryo culture medium does not affect birth outcomes and obstetric complications when comparison is limited to Irvine CSC and Vitrolife G5 PLUS in vitrified-warmed single blastocyst transfer cycles.

摘要

研究问题

使用的培养基类型是否会影响玻璃化冷冻-解冻后单囊胚移植的产科和围产结局?

设计

本研究为回顾性队列研究,纳入了 2013 年至 2020 年间进行玻璃化冷冻-解冻后单囊胚移植且仅培养于 Irvine 连续单培养(CSC)或 Vitrolife G5 PLUS 培养基培养系统的单胎妊娠患者。

结果

共有 2475 名分娩单胎的女性纳入最终分析:1478 名女性的胚胎培养于 CSC,997 名女性的胚胎培养于 G5 PLUS 培养基中。在粗分析和调整分析中,两组间的出生结局(包括早产、平均出生体重、胎龄和性别调整的出生体重(Z 评分)、巨大儿、小于胎龄儿、低出生体重儿和巨大儿的发生率以及新生儿性别分布)均无显著差异。与 CSC 组相比,G5 PLUS 组的女性更常患有妊娠高血压疾病(4.7%比 3.0%;P=0.031)。但在调整了几个关键混杂因素后,这种差异不再显著(调整后的优势比 1.49,95%CI 0.94 至 2.38,P=0.087)。两组的其他产科并发症,包括妊娠期糖尿病、胎膜早破、胎盘异常、产后出血和分娩方式,均相似。

结论

本研究在目前的证据基础上提供了新的信息,表明在玻璃化冷冻-解冻后单囊胚移植周期中,比较仅使用 Irvine CSC 和 Vitrolife G5 PLUS 时,胚胎培养的培养基不会影响出生结局和产科并发症。

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