Clinical outcome of fresh and vitrified-warmed blastocyst and cleavage-stage embryo transfers in ethnic Chinese ART patients.
Clinical outcome of fresh and vitrified-warmed blastocyst and cleavage-stage embryo transfers in ethnic Chinese ART patients.
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中国 ART 患者新鲜和玻璃化加热囊胚和卵裂期胚胎移植的临床结果
DOI：
10.1186/1757-2215-5-27
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发表时间：
2012-10-05
影响因子：
4
通讯作者：
Ling XF
中科院分区：
文献类型：
--
作者：
Tong GQ;Cao SR;Wu X;Zhang JQ;Cui J;Heng BC;Ling XF
目的本研究旨在评估中国少数民族接受抗逆转录病毒治疗的新鲜和玻璃化加热的卵裂期和囊胚期胚胎移植的结果。我们比较取卵后第3天（卵裂期）和第5天（囊胚期）胚胎移植的临床结果，包括临床妊娠率、着床率和多胎妊娠率。结果35岁以下患者的临床妊娠率（41.07% vs 47.08%, p>0.05）和着床率（31.8% vs 31.2%, p>0.05）在第5天进行囊胚移植与第3天进行卵裂期胚胎移植相比无显著性差异。在年龄大于35岁的患者中，囊胚移植后的临床妊娠率较卵裂期胚胎移植略有下降（33.33% vs 42.31%, p < 0.05）。出乎意料的是，玻璃化加热胚泡移植的临床妊娠率（56.8%）和着床率（47%）明显高于受控刺激周期新鲜胚泡移植（分别为41.07%和31.8%）。在35岁以下的患者中，结合新鲜和玻璃化加热胚泡移植周期的累积临床妊娠率明显高于单纯卵裂期胚胎移植（70.1% vs 51.8%, p<0.05）。然而，两组的累积多胎妊娠率无显著差异。结论在中国少数民族患者中，新鲜囊胚移植未显著提高临床妊娠率。然而，在不受控制的卵巢过度刺激周期中，随后的玻璃化加热囊胚移植可显著改善临床结果。因此，囊胚培养与玻璃化加热囊胚移植相结合被推荐为一种有利且有前景的人类ART治疗方案，特别是对华裔患者。
ObjectivesThis study sought to evaluate the outcome of fresh and vitrified-warmed cleavage-stage and blastocyst-stage embryo transfers in patients undergoing ART treatment within an ethnic Chinese population.Study designWe compared the clinical results of embryo transfer on the 3rd (cleavage stage) or 5th (blastocyst stage) day after oocyte retrieval, including clinical pregnancy rates, implantation rates and multiple pregnancy rates.ResultsOur data showed that blastocyst transfer on day 5 did not significantly increase clinical pregnancy rate (41.07% vs 47.08%, p>0.05) and implantation rate (31.8% vs 31.2%, p>0.05) in patients under 35 years of age, in comparison with day 3 cleavage stage embryo transfer. In patients older than 35 years of age, the clinical pregnancy rate after blastocyst transfer was slightly decreased compared with cleavage stage embryo transfer (33.33% vs 42.31%, p>0.05). Unexpectedly, It was found that vitrified-warmed blastocyst transfer resulted in significantly higher clinical pregnancy rate (56.8%) and implantation rate (47%) compared with fresh blastocyst transfer in controlled stimulation cycles (41.07% and 31.8%, respectively). For patients under 35 years of age, the cumulative clinical pregnancy rate combining fresh and vitrified-warmed blastocyst transfer cycles were significantly higher compared to just cleavage-stage embryo transfer (70.1% versus 51.8%, p<0.05). However, the cumulative multiple pregnancy rates showed no significant difference between the two groups.ConclusionsIn an ethnic Chinese patient population, fresh blastocyst transfer does not significantly increase clinical pregnancy rate. However, subsequent vitrified-warmed blastocyst transfer in a non-controlled ovarian hyperstimulation cycle dramatically improves clinical outcomes. Therefore, blastocyst culture in tandem with vitrified-warmed blastocyst transfer is recommended as a favourable and promising protocol in human ART treatment, particularly for ethnic Chinese patients.
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