PROSPECTIVE RANDOMIZED STUDY ON THE CRYOPRESERVATION OF HUMAN EMBRYOS WITH DIMETHYLSULFOXIDE OR 1,2-PROPANEDIOL PROTOCOLS

被引:31
作者
VANDERELST, J [1 ]
CAMUS, M [1 ]
VANDENABBEEL, E [1 ]
MAES, R [1 ]
DEVROEY, P [1 ]
VANSTEIRTEGHEM, AC [1 ]
机构
[1] ERASME UNIV HOSP,B-1070 BRUSSELS,BELGIUM
关键词
CRYOPRESERVATION; HUMAN; EMBRYOS; SURVIVAL; IMPLANTATION; PREGNANCY; DIMETHYL SULFOXIDE; 1,2-PROPANEDIOL;
D O I
10.1016/S0015-0282(16)57302-6
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To investigate the optimal protocol for cryopreservation of human embryos obtained from IVF. Design: Prospective randomized study. Setting: Consenting patients in an academic research environment. Patients: Couples undergoing IVF. Interventions: A cohort of 2,220 supernumerary multicellular embryos were obtained from 488 patients who were randomized over slow freezing protocols with dimethylsulfoxide (DMSO, 819 embryos), 1,2-propanediol (699 embryos) or a mixture of DMSO and 1,2-propanediol (702 embryos). A total of 725 embryos have been thawed (DMSO, 232 embryos; 1,2-propanediol, 250 embryos and DMSO and 1,2-propanediol, 243 embryos) for transfer in natural ovarian cycles. Main Outcome Measures: Embryo survival rate, embryo implantation rate, clinical pregnancy rate (PR), delivery rate, live-birth rate. Results: The embryo survival rate was significantly higher with the DMSO protocol (52.6%) than with the 1,2-propanediol (32.0%) or the DMSO and 1,2-propanediol protocols (34.9%). The clinical PR per thawing cycle was significantly higher in the DMSO protocol (17.2%) than in the 1,2-propanediol protocol (3.9%). The clinical implantation rate per embryo thawed was significantly different between a DMSO-frozen embryo (4.7%) and a 1,2-propanediol-frozen embryo (1.2%). A DMSO and 1,2-propanediol-frozen embryo had a 3.7% chance of implantation. The delivery rate per thawing cycle was significantly higher in the DMSO protocol (12.5%) than in the 1,2-propanediol protocol (2.6%). The live-birth rates per embryo thawed were 3.5%, 0.8%, and 2.9% in the DMSO, 1,2-propanediol, and DMSO and 1,2-propanediol groups, respectively. Conclusion: Supernumerary multicellular embryos as presented in daily clinical IVF practice have the highest chance of survival and of implantation after cryopreservation when DMSO has been used.
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页码:92 / 100
页数:9
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