胚胎双重玻璃化处理对临床结局有不良影响。
Double vitrification of embryos adversely affects clinical outcomes.
机构信息
Embryology Department, Embryolab Fertility Clinic, Thessaloniki, Greece.
Embryolab Academy, Thessaloniki, Greece.
出版信息
JBRA Assist Reprod. 2024 Aug 26;28(3):399-404. doi: 10.5935/1518-0557.20240014.
OBJECTIVE
To evaluate the impact of double embryo vitrification on clinical outcomes.
METHODS
This retrospective cohort study included data from January 2013 to March 2021. The study group included women aged 33.3±5.7 years with double-vitrified embryos (n=381), while the control group included women aged 32.1±6.7 years with embryos vitrified once (n=780), all transferred at the blastocyst stage. The primary endpoint was live birth rate (LBR), and secondary endpoints included percent positive βHCG test, clinical/ongoing pregnancy rates, miscarriage/biochemical pregnancy rates and birthweight.
RESULTS
LBR was significantly lower in double-vitrified embryos (30.2%) than in embryos vitrified once (45.6%, p<.05). Similarly, double-vitrified embryos were associated with significantly lower positive βHCG tests (46% vs. 63.3%, p<.05) and clinical (34.9% vs. 52.2%, p<.05) and ongoing pregnancy (31.3% vs. 47.3%, p<.05) rates compared to embryos vitrified once. However, biochemical pregnancy (double vitrified: 24.1% vs. vitrified once: 17.9%, p>.05) and miscarriage rates (double vitrified: 10.2% vs. vitrified once: 9.4%, p>.05), as well as mean birthweight (double-vitrified embryos: 2950g vs. embryos vitrified once: 2837g, p>.05) did not differ significantly between two groups. On a secondary comparison, amongst double-vitrified embryos, the subgroup that was cultured for more than 24 hours between warming and second vitrification achieved significantly higher positive βHCG tests (49%) and clinical pregnancy (38%) rates, compared to embryos re-vitrified on the same day of warming (31.8% and 20.5%, respectively, p<.05). Nevertheless, LBR did not differ significantly amongst these study-group embryos (embryos that remained in culture for more than 24 hours: 32.2% vs. embryos that were re-vitrified on warming day: 20.5%, p>.05).
CONCLUSIONS
Double vitrification of embryos adversely affects clinical outcomes. However, it represents a valuable option concerning embryo wastage, with acceptable success rates.
目的
评估双胚胎玻璃化冷冻对临床结局的影响。
方法
本回顾性队列研究纳入了 2013 年 1 月至 2021 年 3 月的数据。研究组纳入了年龄 33.3±5.7 岁的双胚胎玻璃化冷冻患者（n=381），对照组纳入了年龄 32.1±6.7 岁的单胚胎玻璃化冷冻患者（n=780），两组均在囊胚期移植。主要结局为活产率（LBR），次要结局包括β-HCG 阳性率、临床妊娠率、持续妊娠率、流产/生化妊娠率和出生体重。
结果
双胚胎玻璃化冷冻组的 LBR 显著低于单胚胎玻璃化冷冻组（30.2% vs. 45.6%，p<.05）。同样，双胚胎玻璃化冷冻组的β-HCG 阳性率（46% vs. 63.3%，p<.05）、临床妊娠率（34.9% vs. 52.2%，p<.05）和持续妊娠率（31.3% vs. 47.3%，p<.05）均显著低于单胚胎玻璃化冷冻组。然而，生化妊娠率（双胚胎玻璃化冷冻组：24.1% vs. 单胚胎玻璃化冷冻组：17.9%，p>.05）和流产率（双胚胎玻璃化冷冻组：10.2% vs. 单胚胎玻璃化冷冻组：9.4%，p>.05）以及出生体重（双胚胎玻璃化冷冻组：2950g vs. 单胚胎玻璃化冷冻组：2837g，p>.05）在两组间无显著差异。在二次比较中，在解冻和二次玻璃化之间培养超过 24 小时的双胚胎玻璃化冷冻亚组，β-HCG 阳性率（49%）和临床妊娠率（38%）显著高于同一天再玻璃化冷冻的胚胎（分别为 31.8%和 20.5%，p<.05）。然而，这些研究组胚胎的 LBR 无显著差异（在培养中超过 24 小时的胚胎：32.2% vs. 在解冻当天再玻璃化冷冻的胚胎：20.5%，p>.05）。
结论
胚胎的双玻璃化冷冻对临床结局有不利影响。然而，对于胚胎浪费，它是一种有价值的选择，具有可接受的成功率。
Zotero 插件