卵子玻璃化冷冻在辅助生殖技术治疗中的临床应用
|
摘要
目的探讨卵子冷冻以及冻卵冻胚(卵裂胚及囊胚)双次冷冻在辅助生殖技术(ART)中临床应用的安全性和可行性。方法回顾性分析2014年1月—2017年12月期间行卵子玻璃化冷冻,随后解冻并后续培养移植共164个周期,其中新鲜胚胎移植组解冻卵88个周期,冻融胚胎移植卵裂胚组冻卵冻胚40个周期,冻融胚胎移植囊胚组冻卵冻囊胚36个周期,并分别以同期未行卵子冷冻的新鲜胚胎(n=1 480)、解冻胚胎(n=246)、解冻囊胚(n=304)移植作为对照,比较卵子受精率、卵裂率及可利用胚胎率,以及各组的复苏率、后续的着床率、临床妊娠率、早期流产率、活产率等指标。结果解冻卵复苏存活率为[94.00%(999/1 063)]。解冻卵受精率[84.00%(838/999)]优于新鲜卵子受精率[72.67%(10 703/14 729)],组间差异有统计学意义(P=0.00),第3日可利用胚胎率、冻融后存活率、着床率、临床妊娠率、早期流产率、活产率差异均无统计学意义(P>0.05)。结论卵子冷冻不会降低卵子的发育潜能,冷冻后可获得比较满意的复苏效果,行卵胞质内单精子显微注射(ICSI)仍可获得较好的妊娠和活产结局,对于需要保存生育力的女性来说卵子冷冻是一种较为安全有效的方法。
Objective To investigate the safety and feasibility of egg vitrification and refrozen embryo in assisted reproductive technology(ART). Methods Patients with intracytoplasmic sperm injection(ICSI) treatment in our hospital from January 2014 to December 2017 were retrospectively analyzed. The thawing egg cycles(n=164, including 88 cycles with frozen eggs, 40 cycles with refrozen embryos, 36 cycles with refrozen blastocyst) were compared with fresh egg cycles in the same period, to get the index of survival rate, fertilization rate, available embryo rate, and subsequent implantation and pregnancy outcomes. Results Survival rate of thawing eggs was 94.00%. The fertilization rate of thawing eggs(84.00%) was significantly higher than that of fresh eggs(72.67%)(P=0.00). And there were no statistical differences in available embryo rate of day 3, embryo survival rate, implantation rate, clinical pregnancy rate, early abortion rate and live birth rate(P>0.05). Conclusion Egg vitrification does not reduce the development potential of the embryo. Frozen eggs can achieve a satisfactory recovery results, with good pregnancy outcomes. In conclusion, for women who need to preserve fertility, egg vitrification is a relatively safe and effective method.
Objective To investigate the safety and feasibility of egg vitrification and refrozen embryo in assisted reproductive technology(ART). Methods Patients with intracytoplasmic sperm injection(ICSI) treatment in our hospital from January 2014 to December 2017 were retrospectively analyzed. The thawing egg cycles(n=164, including 88 cycles with frozen eggs, 40 cycles with refrozen embryos, 36 cycles with refrozen blastocyst) were compared with fresh egg cycles in the same period, to get the index of survival rate, fertilization rate, available embryo rate, and subsequent implantation and pregnancy outcomes. Results Survival rate of thawing eggs was 94.00%. The fertilization rate of thawing eggs(84.00%) was significantly higher than that of fresh eggs(72.67%)(P=0.00). And there were no statistical differences in available embryo rate of day 3, embryo survival rate, implantation rate, clinical pregnancy rate, early abortion rate and live birth rate(P>0.05). Conclusion Egg vitrification does not reduce the development potential of the embryo. Frozen eggs can achieve a satisfactory recovery results, with good pregnancy outcomes. In conclusion, for women who need to preserve fertility, egg vitrification is a relatively safe and effective method.
引文
[1]秦文松,刘英,秦辉灵,等.人卵母细胞玻璃化冷冻技术在辅助生殖中的应用[J].中国性科学,2015,11(2):93-95.DOI:10.3969/j.issn.1672-1993.2015.02.032.
[2]Clark NA,Swain JE.Oosyte cryopreservation:searching for novel improvement strategies[J].J Assist Reprod Genet,2013,30(7):865-875.DOI:10.1007/s10815-013-0028-8.
[3]Leibo SP.Cryopreservation of oocytes and embryos:optimization bu the oretical versus empirical analysis[J].Theriogenology,2008,69(1):37-47.DOI:10.1016/j.theriogenology.2007.10.006.
[4]陈春华,李萍,宋岳强.卵子冷冻研究进展[J].生殖与避孕,2014,34(4):311-316.DOI:10.7669/j.issn.0253-357X.2014.04.0311.
[5]杨云,周新丽,周楠峰,等.卵母细胞冷冻保存技术新进展[J].生殖与避孕,2015,35(3):179-184.DOI:10.7669/j.issn.0253-357X.2015.12.0179.
[6]Zhang L,Yan LY,Zhi X,et al.Female fertility:is it safe to“freeze?”[J].Chin Med J(Engl),2015,128(3):390-397.DOI:10.4103/0366-6999.150115.
[7]Chian RC,Huang JY,Tan SL,et al.Obstetric and perinatal outcome in 200 infants conceived from vitrified oocytes[J].Reprod Biomed Online,2008,16(5):608-610.DOI:10.1016/S1472-6483(10)60471-3.
[8]刘畅,凡秀丽,刘能辉,等.新鲜周期和冻融周期胚胎移植术后发生异位妊娠的相关因素分析[J].中国现代医学杂志,2016,26(7):88-92.DOI:10.3969/j.issn.1005-8982.2016.07.020.
[9]Makrigiannakis A,Karamouti M,Petsas G,et al.The expression of receptvity markers in the fallopian tube epithelium[J].Histochem Cell Biol,2009,132(2):159-167.DOI:10.1007/s00418-009-0593-1.
[10]Zhang Z,Zhu J,Zhang H,et al.Live birth after transfer of vitrified-warmend embryo derived from vitrified-warmed oocyte and frozenthawed sperm following failed ICSI:case report[J].Rev Med Chil,2017,145(3):402-405.DOI:10.4067/S0034-98872017000300017.
[11]Cai LB,Qian XQ,Wang W,et al.Oocyte ivtrification technology has made egg-sharing donation easier in China[J].Reprod Biomed Online,2012,24(2):186-190.DOI:10.1016/j.rbmo.2011.11.002.
[12]Massarotti C,Scaruffi P,Lambertini M,et al.State of the art on oocyte cryopreservation in female cancer patients:a critical review of the literature[J].Cancer Treat Rev,2017,57:50-57.DOI:10.1016/j.ctrv.2017.04.009.
[2]Clark NA,Swain JE.Oosyte cryopreservation:searching for novel improvement strategies[J].J Assist Reprod Genet,2013,30(7):865-875.DOI:10.1007/s10815-013-0028-8.
[3]Leibo SP.Cryopreservation of oocytes and embryos:optimization bu the oretical versus empirical analysis[J].Theriogenology,2008,69(1):37-47.DOI:10.1016/j.theriogenology.2007.10.006.
[4]陈春华,李萍,宋岳强.卵子冷冻研究进展[J].生殖与避孕,2014,34(4):311-316.DOI:10.7669/j.issn.0253-357X.2014.04.0311.
[5]杨云,周新丽,周楠峰,等.卵母细胞冷冻保存技术新进展[J].生殖与避孕,2015,35(3):179-184.DOI:10.7669/j.issn.0253-357X.2015.12.0179.
[6]Zhang L,Yan LY,Zhi X,et al.Female fertility:is it safe to“freeze?”[J].Chin Med J(Engl),2015,128(3):390-397.DOI:10.4103/0366-6999.150115.
[7]Chian RC,Huang JY,Tan SL,et al.Obstetric and perinatal outcome in 200 infants conceived from vitrified oocytes[J].Reprod Biomed Online,2008,16(5):608-610.DOI:10.1016/S1472-6483(10)60471-3.
[8]刘畅,凡秀丽,刘能辉,等.新鲜周期和冻融周期胚胎移植术后发生异位妊娠的相关因素分析[J].中国现代医学杂志,2016,26(7):88-92.DOI:10.3969/j.issn.1005-8982.2016.07.020.
[9]Makrigiannakis A,Karamouti M,Petsas G,et al.The expression of receptvity markers in the fallopian tube epithelium[J].Histochem Cell Biol,2009,132(2):159-167.DOI:10.1007/s00418-009-0593-1.
[10]Zhang Z,Zhu J,Zhang H,et al.Live birth after transfer of vitrified-warmend embryo derived from vitrified-warmed oocyte and frozenthawed sperm following failed ICSI:case report[J].Rev Med Chil,2017,145(3):402-405.DOI:10.4067/S0034-98872017000300017.
[11]Cai LB,Qian XQ,Wang W,et al.Oocyte ivtrification technology has made egg-sharing donation easier in China[J].Reprod Biomed Online,2012,24(2):186-190.DOI:10.1016/j.rbmo.2011.11.002.
[12]Massarotti C,Scaruffi P,Lambertini M,et al.State of the art on oocyte cryopreservation in female cancer patients:a critical review of the literature[J].Cancer Treat Rev,2017,57:50-57.DOI:10.1016/j.ctrv.2017.04.009.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |