胚胎双重玻璃化会对临床结果产生不利影响。

IF 1.8 Q3 OBSTETRICS & GYNECOLOGY Jornal Brasileiro de Reproducao Assistida Pub Date : 2024-08-26 DOI:10.5935/1518-0557.20240014
Chara Oraiopoulou, Mary Karagianni, Achilleas Papatheodorou, Olga Toumpa, Marianna Papadopoulou, Nicholaos Christophoridis, Panagiotis Drakopoulos, Alexia Chatziparasidou
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摘要

目的:评估双胚胎玻璃化对临床结果的影响:评估双胚胎玻璃化对临床结果的影响:这项回顾性队列研究包括2013年1月至2021年3月的数据。研究组包括年龄为 33.3±5.7 岁、胚胎经过两次玻璃化处理的女性(381 人),对照组包括年龄为 32.1±6.7 岁、胚胎经过一次玻璃化处理的女性(780 人),所有胚胎均在囊胚期移植。主要终点是活产率(LBR),次要终点包括βHCG检测阳性率、临床/持续妊娠率、流产/生化妊娠率和出生体重:双重玻璃化胚胎的LBR(30.2%)明显低于一次性玻璃化胚胎(45.6%,P.05),流产率(双重玻璃化:10.2% vs. 一次性玻璃化:9.4%,P>.05)和平均出生体重(双重玻璃化胚胎:2950克 vs. 一次性玻璃化胚胎:2837克,P>.05)在两组间无明显差异。经二次比较,在两次玻璃化的胚胎中,在升温和第二次玻璃化之间培养超过24小时的亚组,βHCG检测阳性率(49%)和临床妊娠率(38%)明显高于在升温当天再次玻璃化的胚胎(分别为31.8%和20.5%,P.05):结论:胚胎双重玻璃化会对临床结果产生不利影响。结论:胚胎双重玻璃化会对临床结果产生不利影响,但它是解决胚胎浪费问题的一种有价值的选择,其成功率是可以接受的。
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Double vitrification of embryos adversely affects clinical outcomes.

Objective: To evaluate the impact of double embryo vitrification on clinical outcomes.

Methods: This retrospective cohort study included data from January 2013 to March 2021. The study group included women aged 33.3±5.7 years with double-vitrified embryos (n=381), while the control group included women aged 32.1±6.7 years with embryos vitrified once (n=780), all transferred at the blastocyst stage. The primary endpoint was live birth rate (LBR), and secondary endpoints included percent positive βHCG test, clinical/ongoing pregnancy rates, miscarriage/biochemical pregnancy rates and birthweight.

Results: LBR was significantly lower in double-vitrified embryos (30.2%) than in embryos vitrified once (45.6%, p<.05). Similarly, double-vitrified embryos were associated with significantly lower positive βHCG tests (46% vs. 63.3%, p<.05) and clinical (34.9% vs. 52.2%, p<.05) and ongoing pregnancy (31.3% vs. 47.3%, p<.05) rates compared to embryos vitrified once. However, biochemical pregnancy (double vitrified: 24.1% vs. vitrified once: 17.9%, p>.05) and miscarriage rates (double vitrified: 10.2% vs. vitrified once: 9.4%, p>.05), as well as mean birthweight (double-vitrified embryos: 2950g vs. embryos vitrified once: 2837g, p>.05) did not differ significantly between two groups. On a secondary comparison, amongst double-vitrified embryos, the subgroup that was cultured for more than 24 hours between warming and second vitrification achieved significantly higher positive βHCG tests (49%) and clinical pregnancy (38%) rates, compared to embryos re-vitrified on the same day of warming (31.8% and 20.5%, respectively, p<.05). Nevertheless, LBR did not differ significantly amongst these study-group embryos (embryos that remained in culture for more than 24 hours: 32.2% vs. embryos that were re-vitrified on warming day: 20.5%, p>.05).

Conclusions: Double vitrification of embryos adversely affects clinical outcomes. However, it represents a valuable option concerning embryo wastage, with acceptable success rates.

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