Ziebe S, Bech B, Petersen K, Mikkelsen A L, Gabrielsen A, Andersen A N
The Fertility Clinic, The Juliane Marie Center, Rigshospitalet, University of Copenhagen, Denmark.
Hum Reprod. 1998 Jan;13(1):178-81. doi: 10.1093/humrep/13.1.178.
This retrospective study of 701 thaw cycles analysed the clinical importance of whether or not embryos resumed mitosis during 24 h of post-thaw culture. A total of 3360 frozen embryos were thawed; 1922 embryos survived the freeze-thaw procedure with at least one intact blastomere and were then cultured for 24 h before transfer. All transfers were registered into either the 'cleaved embryo group' (n = 459), which was defined as transfers where at least one of the transferred embryos cleaved during the post-thaw culture period, or the 'non-cleaved embryo group' (n = 153), where none of the transferred embryos cleaved during the post-thaw culture period. A total of 1408 thawed embryos were transferred in 612 cycles; 459 embryo transfers were in the cleaved embryo group, resulting in an implantation rate of 10%, significantly higher than the 4% in the non-cleaved embryo group (P = 0.0003). A total of 130 pregnancies (28% per transfer) were obtained in the cleaved embryo group which was significantly higher than the 17 pregnancies (11% per transfer) obtained in the non-cleaved embryo group (P = 0.0001). However, the average number of transferred embryos was significantly higher in the cleaved embryo group (2.46 +/- 0.03) compared to the non-cleaved embryo group (1.82 +/- 0.07). No difference was found in the age of the women between the two groups. When analysing transfers where all transferred embryos had cleaved during the post-thaw culture period the clinical pregnancy rate increased significantly from 13% transferring two embryos to 36% transferring three embryos (P = 0.0136). In this latter subgroup an implantation rate as high as 17% was obtained. The overall multiple pregnancy rate was 16%. The multiple pregnancy rate was 19% in the cleaved embryo group. In conclusion, 24 h post-thaw culture may allow a better selection of the embryos and thereby we may be able to increase the implantation and pregnancy rates. This may enable us further to reduce the number of embryos transferred.
这项对701个解冻周期的回顾性研究分析了胚胎在解冻后培养24小时内是否恢复有丝分裂的临床重要性。总共解冻了3360个冷冻胚胎；1922个胚胎在冻融过程后存活，至少有一个完整的卵裂球，然后在移植前培养24小时。所有移植被记录到“卵裂胚胎组”（n = 459），该组定义为在解冻后培养期内至少有一个移植胚胎发生卵裂的移植，或“未卵裂胚胎组”（n = 153），即解冻后培养期内所有移植胚胎均未发生卵裂的移植。在612个周期中总共移植了1408个解冻胚胎；459例胚胎移植在卵裂胚胎组，着床率为10%，显著高于未卵裂胚胎组的4%（P = 0.0003）。卵裂胚胎组共获得130例妊娠（每次移植28%），显著高于未卵裂胚胎组获得的17例妊娠（每次移植11%）（P = 0.0001）。然而，卵裂胚胎组移植胚胎的平均数量（2.46 +/- 0.03）显著高于未卵裂胚胎组（1.82 +/- 0.07）。两组女性的年龄没有差异。当分析解冻后培养期内所有移植胚胎均发生卵裂的移植时，临床妊娠率从移植两个胚胎时的13%显著提高到移植三个胚胎时的36%（P = 0.0136）。在这后一个亚组中获得了高达17%的着床率。总体多胎妊娠率为16%。卵裂胚胎组的多胎妊娠率为19%。总之，解冻后24小时培养可能有助于更好地选择胚胎，从而我们可能能够提高着床率和妊娠率。这可能使我们能够进一步减少移植胚胎的数量。
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