背景:胚胎的冷冻保存在体外受精(IVF)/卵胞浆内单精子注射(ICSI)治疗中起着重要作用。然而,在冷冻保存期间的实际应用期间,由于胚胎从液氮(LN2)罐中重复取回,冷冻保存的胚胎的储存条件可能暂时改变。当包含冷冻保存的胚胎的甘蔗由于LN2罐和LN2容器之间的转移而暂时暴露于空气时,冷冻保存的胚胎的植入潜力是否会受到损害尚待阐明。此外,冷冻保存胚胎的暴露于空气的频率(EAF)是否会影响临床结局尚不清楚.
目的:探讨冷冻胚胎的EAF是否影响玻璃化温热胚胎移植的临床结局。
方法:本研究共纳入9200个玻璃化升温胚胎移植周期。根据不同的EAF(2、4、6、8或≥10)将所有周期分为五组。变暖后生存率和临床结果,包括植入,调查了临床妊娠和活产率。使用Kruskal-Wallis检验和Pearson卡方检验比较五组患者特征和临床结局。此外,进行多因素logistic回归分析以研究EAF与临床结局之间的关联。
结果:HCG阳性率无显著差异,5个EAF组的D3胚胎着床率和活产率(P>0.05),D5囊胚和D6囊胚。5个EAF组的D3胚胎的温热后存活率(P=0.015)差异显著,但它不是EAF依赖性的。尽管在D5囊胚方面5组的临床妊娠不同(P=0.042),对混杂变量进行校正的多变量逻辑回归分析显示,EAF对临床妊娠或活产没有不利影响。
结论:这些发现表明,开放系统中的人玻璃化胚胎可以从LN2罐中反复回收,而不会影响胚胎的植入潜力。
BACKGROUND: Cryopreservation of embryos plays a major role in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. However, the storage condition of the cryopreserved embryo can change temporarily due to repeated retrieval of the embryo from the liquid nitrogen (LN2) tank during the practical application during cryopreservation. Whether the implantation potential of a cryopreserved embryo will be damaged when the cane containing it is temporarily exposed to air due to the transfer between the LN2 tank and LN2 container is yet to be elucidated. Also, whether the exposed-to-air frequency (
EAF) of cryopreserved embryos influences the clinical outcomes is unclear.
OBJECTIVE: To investigate whether the
EAF of cryopreserved embryo affects the clinical outcomes of vitrified-warmed embryo transfer.
METHODS: A total of 9200 vitrified-warmed embryo transfer cycles were included in this study. All cycles were divided into five groups according to different EAFs (2, 4, 6, 8, or ≥ 10). Post-warming survival rates and clinical outcomes, including implantation, clinical pregnancy and live birth rates were investigated. Kruskal-Wallis test and Pearson\'s chi-squared tests were used to compare the patient characteristics and clinical outcomes among the five groups. Furthermore, multivariate logistic regression analyses were conducted to investigate the association between EAF and clinical outcomes.
RESULTS: No significant differences were observed in the positive HCG rate, implantation rate and live birth rate (P > 0.05) among five
EAF groups with respect to D3 embryo, D5 blastocyst and D6 blastocyst. Post-warmed survival rate of D3 embryos (P = 0.015) differed significantly among the five
EAF groups, but it was not
EAF-dependent. Although clinical pregnancy was different among the five groups with respect to D5 blastocyst (P = 0.042), multivariate logistic regression analysis adjusted for confounding variables suggested that EAF did not adversely affect clinical pregnancy or live birth.
CONCLUSIONS: These findings indicated that human vitrified embryos in the open system could be repeatedly retrieved from the LN2 tank without affecting the implantation potential of the embryo.