冻融第5天和第6天囊胚发育潜能的差异比较及其与妊娠结局的关系。
Comparison of differences in development potentials between frozen-thawed D5 and D6 blastocysts and their relationship with pregnancy outcomes.
作者信息
Yang Hongyi, Yang Qingling, Dai Shanjun, Li Gang, Jin Haixia, Yao Guidong, Sun Yingpu
机构信息
Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, China.
出版信息
J Assist Reprod Genet. 2016 Jul;33(7):865-72. doi: 10.1007/s10815-016-0712-6. Epub 2016 Apr 21.
PURPOSE
Whether there are differences in the pregnancy outcomes of blastocysts cryopreserved during different developmental stages remains under debate because the results among studies are inconsistent. We analyzed blastocyst quality and pregnancy outcomes by considering blastocyst euploidy and investigated the differences in the development potential between blastocysts of different developmental stages (frozen-thawed day 5 [D5] and day 6 [D6] cycles) and their relationship with clinical pregnancy outcomes.
METHODS
In total, 1374 D5 and 255 D6 frozen-thawed blastocyst transfer cycles were retrospectively analyzed. Additionally, the chromosome euploidy and clinical pregnancy rates of 237 blastocysts from 50 pre-implantation genetic diagnosis (PGS) cycles were statistically analyzed. The corresponding euploidy rate and pregnancy outcomes of the D5 and D6 blastocyst transfers were also compared.
RESULTS
The clinical pregnancy rate (47.2 vs 40.0 %; P = 0.04) and implantation rate (34.2 vs 28.8 %; P = 0.03) of the D5 blastocysts were higher than were those of the D6 blastocysts. However, the clinical pregnancy rate (52.4 vs 52.6 %; P = 0.97) and implantation rate (38.9 vs 35.6 %; P = 0.39) of the high-quality D5 blastocysts did not significantly differ from those of the high-quality D6 blastocysts. Analysis of blastocyst euploidy in 237 blastocysts examined in 50 PGS cycles showed that the euploidy rates of the D5 and D6 blastocysts were both 48.1 % (P = 0.99). The clinical pregnancy rate of the D5 blastocysts (48.5 vs 17.6 %; P = 0.03) was higher than that of the D6 blastocysts. The euploidy rates (55.2 vs 55.3 %; P = 0.99) and clinical pregnancy rates (60.0 vs 42.9 %; P = 0.77) of the high-quality D5 and D6 blastocysts did not differ. The euploidy rate (55.3 vs 41.5 %, P = 0.03) and clinical pregnancy rate (54.5 vs 25.0 %, P = 0.03) of the high-quality blastocysts were higher than were those of the poor-quality blastocysts.
CONCLUSIONS
The euploidy rates between the D5 and D6 blastocysts did not differ. High-quality D6 blastocysts in frozen-thawed cycles had similar developmental potential and pregnancy outcomes compared to those of high-quality D5 blastocysts. The quality of the blastocysts was an important factor that affected the pregnancy outcomes of the frozen-thawed cycles.
目的
由于研究结果不一致，不同发育阶段冷冻保存的囊胚妊娠结局是否存在差异仍存在争议。我们通过考虑囊胚整倍体来分析囊胚质量和妊娠结局，并研究不同发育阶段（冻融周期第5天[D5]和第6天[D6]）囊胚的发育潜能差异及其与临床妊娠结局的关系。
方法
回顾性分析了1374个D5和255个D6冻融囊胚移植周期。此外，对来自50个植入前遗传学诊断（PGS）周期的237个囊胚的染色体整倍体和临床妊娠率进行了统计分析。还比较了D5和D6囊胚移植的相应整倍体率和妊娠结局。
结果
D5囊胚的临床妊娠率（47.2%对40.0%；P = 0.04）和着床率（34.2%对28.8%；P = 0.03）高于D6囊胚。然而，高质量D5囊胚的临床妊娠率（52.4%对52.6%；P = 0.97）和着床率（38.9%对35.6%；P = 0.39）与高质量D6囊胚无显著差异。对50个PGS周期中检测的237个囊胚进行的囊胚整倍体分析显示，D5和D6囊胚的整倍体率均为48.1%（P = 0.99）。D5囊胚的临床妊娠率（48.5%对17.6%；P = 0.03）高于D6囊胚。高质量D5和D6囊胚的整倍体率（55.2%对55.3%；P = 0.99）和临床妊娠率（60.0%对42.9%；P = 0.77）无差异。高质量囊胚的整倍体率（55.3%对41.5%，P = 0.03）和临床妊娠率（54.5%对25.0%，P = 0.03）高于低质量囊胚。
结论
D5和D6囊胚的整倍体率无差异。冻融周期中的高质量D6囊胚与高质量D5囊胚相比，具有相似的发育潜能和妊娠结局。囊胚质量是影响冻融周期妊娠结局的重要因素。
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