Influence of post-thaw culture duration on pregnancy outcomes in frozen blastocyst transfer cycles
Influence of post-thaw culture duration on pregnancy outcomes in frozen blastocyst transfer cycles
复制标题
冷冻囊胚移植周期中解冻后培养时间对妊娠结局的影响
DOI：
10.1080/19396368.2022.2121191
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发表时间：
2022-09-28
影响因子：
2.4
通讯作者：
Ling, Xiufeng
中科院分区：
文献类型：
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作者：
Ji, Hui;Cao, Shanren;Ling, Xiufeng
在本研究中，我们旨在评估解冻后培养时间是否影响冷冻囊胚移植的临床结果。这项回顾性队列研究包括3901个冻融囊胚移植周期。根据发育阶段（第5天[D5]和第6天[D6]）和解冻后培养时间（短培养，2-6 h；长培养，18-20 h）将队列分为两组。D6囊胚移植后短培养组的女性根据解冻后培养时间（2、4和6小时）进一步分为三个亚组。D5囊胚移植后各组主要指标活产率（LBR）、着床率（IR）、临床妊娠率（CPR）、流产率（AR）差异无统计学意义。D6囊胚移植后，长培养组患者IR（35.5比45.8%,p < 0.001）、CPR（45.3比56.6%,p = 0.001）和LBR（35.5比48.5%,p < 0.001）显著低于短培养组，但AR（21.6比14.3%,p = 0.049）显著高于短培养组。然而，该数据未能显示任何短培养时间对D6玻璃化胚胎的活产结果的优势（4小时与2小时亚组的调整优势比[aOR]: 0.96, 95%可信区间[95% CI]: 0.53-1.73, p = 0.881； 6小时与2小时亚组的调整优势比[aOR]: 1.01, 95% CI: 0.68-1.49, p = 0.974）。两种解冻后方案均可应用于D5囊胚患者。为了优化D6囊胚移植后的妊娠结局，建议缩短培养时间。根据实验室的工作流程，可以应用三种短培养时间（2,4和6小时）中的任何一种。
Abstract In this study, we aimed to evaluate whether post-thaw culture duration affected the clinical outcomes of frozen blastocyst transfer. This retrospective cohort study included 3,901 frozen-thawed blastocyst transfer cycles. The cohorts were divided into two groups based on the developmental stage (day 5 [D5] and day 6 [D6]) and culture duration after thawing (short culture, 2–6 h; long culture, 18–20 h). Women in the short culture group following D6 blastocyst transfer were further divided into three subgroups depending on the post-thaw culture period (2, 4, and 6 h). The main outcomes, namely live birth rate (LBR), implantation rate (IR), clinical pregnancy rate (CPR), and abortion rate (AR), showed no statistical differences within the groups following D5 blastocyst transfer. Patients in the long culture group had significantly lower IR (35.5 vs. 45.8%, p < 0.001), CPR (45.3 vs. 56.6%, p = 0.001), and LBR (35.5 vs. 48.5%, p < 0.001) but a significantly higher AR (21.6 vs. 14.3%, p = 0.049) following D6 blastocyst transfer than those in the short culture group. However, the data failed to present the superiority of any short culture duration over another on the live birth outcome for embryos vitrified on D6 (adjusted odds ratio [aOR]: 0.96, 95% confidence interval [95% CI]: 0.53–1.73, p = 0.881, for the 4-h vs. 2-h subgroup; aOR: 1.01, 95% CI: 0.68–1.49, p = 0.974, for the 6-h vs. 2-h subgroup). Both post-thaw protocols can be applied to patients with D5 blastocysts. To optimize the pregnancy outcomes following D6 blastocyst transfer, a short culture period is recommended. Any of the three short culture durations (2, 4, and 6 h) can be applied, depending on the workflow of the laboratory.