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[人类胚胎冷冻保存]

[Human embryo cryopreservation].

作者信息

Kamiya H, Moriwaka O

机构信息

Tonan Hospital, Sapporo, Japan.

出版信息

Hum Cell. 1997 Mar;10(1):39-44.

PMID:9234063
Abstract

Widespread incorporation of human embryo cryopreservation into in-vitro fertilization (IVF) programs may reduce the risk of multiple gestation and severe ovarian hyperstimulation syndrome while contributing to an overall increase in pregnancy rates. The main known complication arising from ovarian stimulation is ovarian hyperstimulation syndrome (OHSS). The development of severe OHSS is contingent on either exogenous administration of hCG or endogenous pregnancy-derived hCG stimulation. The rationale behind the strategy of electively cryopreserving all embryos from woman at risk of developing OHSS is therefore to avoid these additional influences of the exogenous and trophoblastic HCG upon the ovary. Successful implantation depends on embryo quality and uterine receptivity. If a good embryo was present, among those in the cleavage stage, the pregnancy rate was significantly higher (41.5%) after the transfer of embryos at the 3 approximately 4 cell stage in the cases of pronuclear-stage freezing. A significantly higher pregnancy rate of multilayered echogenic patterns was observed when pregnancy and nonpregnancy cycles were compared. No differences in mean endometrial thickness were observed when pregnancy and non pregnancy cycles were compared. No pregnancies occurred when endometrial thickness was less than 5 millimeters. A statistically significant decrease in pregnancy rate was seen when thawed embryo transfer is performed in a natural cycle in patients who were 35 to 39 years old. No age-related decline was seen in patients in which transfer was performed in the hormone replacement cycle.

摘要

将人类胚胎冷冻保存广泛纳入体外受精(IVF)程序,可能会降低多胎妊娠和严重卵巢过度刺激综合征的风险,同时有助于整体提高妊娠率。已知卵巢刺激引起的主要并发症是卵巢过度刺激综合征(OHSS)。严重OHSS的发生取决于外源性给予hCG或内源性妊娠衍生的hCG刺激。因此,对于有发生OHSS风险的女性,选择性冷冻保存所有胚胎这一策略的基本原理是避免外源性和滋养层HCG对卵巢的这些额外影响。成功着床取决于胚胎质量和子宫容受性。如果存在优质胚胎,在卵裂期胚胎中,原核期冷冻情况下,在大约3至4细胞阶段移植胚胎后的妊娠率显著更高(41.5%)。比较妊娠周期和非妊娠周期时,观察到多层回声模式的妊娠率显著更高。比较妊娠周期和非妊娠周期时,未观察到平均子宫内膜厚度有差异。当子宫内膜厚度小于5毫米时,未发生妊娠。35至39岁的患者在自然周期进行解冻胚胎移植时,妊娠率出现统计学显著下降。在激素替代周期进行移植的患者中,未观察到与年龄相关的下降。

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