目的 比较第5天(D5)和第6天(D6)囊胚期玻璃化冻融胚胎移植的临床结局,分析自然周期和替代周期对囊胚期冻融胚胎移植的影响.方法 将移植后剩余胚胎进行囊胚培养至D5或D6后行玻璃化冻融,比较囊胚复苏后的临床妊娠率、自然流产率及种植率等指标.结果D5组解冻154个囊胚,153个存活,复苏存活率99.4％；D6组解冻100个囊胚,99个存活,复苏存活率99％,两组复苏存活率无显著性差异(P＞0.05).总临床妊娠率D5组(54.4％)显著高于D6组(20％)(P＜0.01).自然流产率D5组为6.1％,而D6组则为9.1％,两组相比,无统计学差异(P＞0.05).种植率D5组(41.2％),显著高于D6组(11.1％)(P＜0.01).替代周期组(HRT)和自然周期组(NC)相比,NC组的临床妊娠宰及种植率均高于HRT组,但均无显著性差异(P＞0.05).结论D5囊胚冷冻复苏后移植能获得较好的妊娠结局,内膜准备方法不同即替代周期和自然周期对临床结果并无影响.%Objective: To compare the clinical outcome of vitrified-thawed human blastocysts at day 5 (D5) or day 6 (D6) in natural cycle or hormone replacement therapy cycle.Methods: In IVF-ET cycles, supernumerary embryos were cultured to D5 or D6, and the blastocysts were vitrified. The clinical pregnant rate, abortion rate and implantation rate were compared.Results; In D5 group, 154 blastocysts were thawed, and 153(99. 4%)of them were survived. There were 49 women got clinically pregnant (54. 4%), but 3 (6. 1%) of them suffered from miscarriage. In D6 group, 100 blastocysts were thawed, and 99(99%)of them were survived, 11 women (20%) got clinical pregnancy, 1 (9. 1%) of them miscarried, the other 10 pregnancies were ongoing. The clinically pregnant rate and implantation rate in D5 group were both significantly higher than those of D6 group (P<0. 01). In addition, there were no significant difference in the clinical pregnancy rate and implantation rate between natural cycles and hormone replacement therapy cycles (P>0. 05).Conclusions: The vitrified-thawed blastocysts at D5 could get better outcomes, and different programs of endometrium preparation by natural cycles or hormone replacement therapy had no different effect on clinical outcomes.
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