Outcomes of vitrified-warmed cleavage-stage embryo hatching after in vitro laser-assisted zona pellucida thinning in patients.
Outcomes of vitrified-warmed cleavage-stage embryo hatching after in vitro laser-assisted zona pellucida thinning in patients.
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DOI：
10.3892/br.2016.716
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发表时间：
2016-09
影响因子：
2.3
通讯作者：
En-Hua Wang;An-Cong Wang;Bao-Song Wang;Bin Li
中科院分区：
文献类型：
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作者：
En-Hua Wang;An-Cong Wang;Bao-Song Wang;Bin Li
本研究的目的是确定是否透明带（ZP）的激光辅助孵化薄化区域的大小影响玻璃化加温胚胎的潜在发展。总共196个玻璃化加温的卵裂期胚胎（来自49名患者，每名患者4个姐妹胚胎）用于该研究，即，每个患者的四个姐妹胚胎被随机分配到四组：对照组的胚胎没有被区域操作，一个实验组是用激光辅助的ZP减薄法减薄四分之一透明带的胚胎（B组），另一个实验组是减薄一半透明带的胚胎（C组），另一个实验组是用激光辅助的ZP减薄法减薄四分之一透明带的胚胎（B组）。第三组（D组），ZP的三分之二变薄。评估随后的囊胚发育。用显微镜观察了疏枝后胚胎的孵化过程。囊胚形成率A组为71.43%，B组为67.35%，C组为65.31%，D组为51.02%（B ~ D组与A组相比，P=0.661，P=0.515，P=0.038）。完全孵化率A组为30.61%，B组为38.78%，C组为61.22%，D组为48.98%（B ~ D组与A组比较，P=0.396，P=0.002，P=0.063）。对于一个患者亚组，年龄<35岁的妇女在所有组中的完全孵化差异有统计学意义（P=0.011），继发性不孕妇女在所有组中的完全孵化差异有统计学意义（P=0.022）。年龄≥35岁的不同年龄组的囊胚形成率差异无统计学意义（P=0.340）。年龄≥35岁的妇女中，不同年龄组的完全孵化率差异无统计学意义（P=0.492）。本研究结果表明，在卵裂期玻璃化冷冻-温育胚胎移植中，三分之二透明带减薄组囊胚形成率显著低于对照组，而半透明带减薄组囊胚完全孵化率显著高于对照组，具有较高的临床应用价值。
The aim of the present study was to determine whether the size of the zona pellucida (ZP) thinning area by laser-assisted hatching affected the potential development of vitrified-warmed embryos. A total of 196 vitrified-warmed cleavage-stage embryos (from 49 patients, four sister embryos per patient) were used in the study, i.e., four sister embryos from each patient were randomly assigned to four groups: a control group of embryos that were not zona-manipulated (zona intact, group A); one experimental group of embryos in which a quarter of the zona pellucida was thinned using laser-assisted ZP thinning (group B); a second experimental group of embryos in which half of ZP was thinned (group C); and a third group in which two-thirds of the ZP was thinned (group D). Subsequent blastocyst development was assessed. Microscopy was performed to study the hatching process of the embryos after zona thinning. The blastocyst formation rates were 71.43% in group A, 67.35% in group B, 65.31% in group C, and 51.02% in group D (groups B-D vs. group A, P=0.661, P=0.515, P=0.038, respectively). The rates of complete hatching were 30.61% in group A, 38.78% in group B, 61.22% in group C, and 48.98% in group D (groups B-D vs. group A, P=0.396, P=0.002, P=0.063, respectively). For a subgroup of patients, there was a significant difference in the complete hatching in all the groups for women aged <35 years (P=0.011), and there was a significant difference in the complete hatching in all the groups for secondary infertility women (P=0.022). There was no significant difference in the blastocyst formation rates in the different groups of women aged ≥35 years (P=0.340). In addition, there was no significant difference in the complete hatching in the different groups among women aged ≥35 years (P=0.492). The results of the present study showed that in vitrified-warmed embryo transfers at the cleavage-stage, and the two-thirds zona pellucida thinning group demonstrated a significantly decreased blastocyst formation rate compared with the control group, while the half zona pellucida thinning group demonstrated a significantly increased complete hatching rate compared with the control group, which may have a high value in clinical application.