Rossella Fucci, Patrizia Falcone, Francesco Capodanno, Sara Rubini, Andrea Gallinelli, Vincenzo Lofiego, Silvia De Stefani, Mariangela Primiterra, Elisabetta Coccia, Elisabetta Baldi, Simone Palini
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引用次数: 0
Abstract
Research question: What effect does the use of a rapid warming method of vitrified embryos have on survival and pregnancy?
Design: A comparison of two different warming embryos protocols: long protocol (group 1, n = 486) and a new fast protocol (group 2, n = 413) for blastocyst and cleavage stage frozen embryo transfers at two IVF centres: Assisted Reproductive Technology Centre, Careggi University Hospital Firenze and IVF Unit, 'Cervesi' Hospital Cattolica. Total pregnancy rate was considered primary outcome, and embryo survival rate, clinical pregnancy rate, miscarriage rate, ongoing pregnancy rate and mean time required for warming procedure were considered secondary outcomes.
Results: The same embryo survival rate was observed in the two groups. Total and clinical pregnancy rates seemed to be higher, but not statistically different, in group 2 compared with group 1 (29.5% versus 26.7% and 27.6% versus 22.6%, respectively). Conversely, a statistically significant reduction in miscarriage rate was found in group 2 compared with group 1 (18.0% versus 32.3%, P = 0.009). Similarly, a significant increase in pregnancy rate at 26 gestational weeks or over was observed in group 2 compared with group 1 (66.9% versus 80.3%, P = 0.016). Finally, a difference in time required for warming procedures was found in favour of group 2.
Conclusions: The use of the fast warming protocol is a valid alternative to the classic warming protocol, and allows a reduction in the time needed to carry out the procedure and the workload of embryologists in an IVF laboratory.
研究问题：使用玻璃化胚胎的快速加热方法对存活和怀孕有什么影响？设计：比较两种不同的加热胚胎方案：在两个体外受精中心（辅助生殖技术中心，佛罗伦萨Careggi大学医院和卡托利卡Cervesi医院体外受精部）进行囊胚和卵分裂期冷冻胚胎移植的长方案（第1组， = 486）和新的快速方案（第2组， = 413）。总妊娠率被认为是主要结局，胚胎存活率、临床妊娠率、流产率、持续妊娠率和平均升温所需时间被认为是次要结局。结果：两组胚胎存活率相同。2组总妊娠率和临床妊娠率似乎高于1组，但无统计学差异（分别为29.5%比26.7%和27.6%比22.6%）。相反，与1组相比，2组流产率明显降低（18.0% vs 32.3%, P = 0.009）。同样，与1组相比，2组26孕周及以上的妊娠率显著增加（66.9% vs 80.3%, P = 0.016）。最后，发现加热程序所需的时间差异有利于第2组。结论：使用快速升温方案是经典升温方案的有效替代方案，并且可以减少执行程序所需的时间和体外受精实验室胚胎学家的工作量。
期刊介绍：
Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients.
Context:
The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.
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