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目的:探讨透明带薄化法激光辅助孵化技术对慢速冷冻和玻璃化冷冻卵裂期胚胎临床结局的影响。方法:回顾性分析复苏后至少有1个胚胎是完整存活的564例卵裂期冻融胚胎移植周期,根据胚胎移植前是否行激光辅助孵化,分为辅助孵化组(研究组)与非辅助孵化组(对照组),分别观察透明带薄化法激光辅助孵化技术对慢速冷冻胚胎及玻璃化冷冻胚胎的临床妊娠率、种植率及流产率的影响。结果:胚胎经慢速冷冻后,研究组胚胎种植率(19.5%)显著高于对照组(13.5%),差异有统计学意义(P<0.05),而临床妊娠率及流产率(37.9%vs 28.5%、15.5%vs 10.8%)无显著差异;胚胎经玻璃化冷冻后,研究组和对照组胚胎的临床妊娠率(38.0%vs 35.6%)、种植率(17.3%vs 15.9%)及流产率(7.6%vs 19.2%)相比较均无统计学差异;研究组中来源于2种冷冻方法的卵裂期胚胎的临床妊娠率(37.9%vs 38.0%)和种植率(19.5%vs 17.3%)无统计学差异(P>0.05)。结论:透明带薄化法激光辅助孵化能够提高慢速冷冻的卵裂期胚胎的种植能力,且不会增加其流产风险,但并不能提高玻璃化冷冻的卵裂期胚胎的种植能力。
OBJECTIVE: To investigate the effects of laser-assisted incubation with thinning of zona pellucida on the clinical outcomes of slow-freezing and vitrification embryos with cryogenic stage. Methods: A retrospective analysis of at least one embryo after resuscitation was performed in 564 cases of intact frozen-thawed embryos. According to whether laser-assisted hatching was performed before embryo transfer, there were two groups: assisted hatching group (study group) and non-assisted hatching (Control group). The effects of laser assisted hatching technique with thinning of zona pellucida on clinical pregnancy rate, implantation rate and abortion rate of slow frozen embryo and vitrified frozen embryo were observed. Results: The embryo implantation rate (19.5%) was significantly higher than that of the control group (13.5%) after slow freezing, the difference was statistically significant (P <0.05), while the clinical pregnancy rate and abortion rate (37.9% vs 28.5%, 15.5% vs 10.8%, respectively). After embryo vitrification, the clinical pregnancy rate (38.0% vs 35.6%), implantation rate (17.3% vs 15.9%) and abortion rate (7.6% vs 19.2%). The clinical pregnancy rate (37.9% vs 38.0%) and the implantation rate (19.5% vs 17.3%) in the cleavage stage embryos from the two freezing methods in the study group were significantly lower No statistical difference (P> 0.05). CONCLUSION: Laser-assisted incubation with zona blossoms can increase the ability of slow-frozen cleavage stage embryos to grow without increasing the risk of miscarriage, but does not improve the ability of vitrification to harden cleavage stage embryos.