人胚胎移植后剩余胚胎继续体外培养潜能的研究  

Potential development to blastocyst of the surplus embryos from human embryo transfer

作　　者：薛侠 赵皖秋 张四林 秦臻 师娟子 

机构地区：[1]陕西省妇幼保健院生殖中心,陕西西安710003

出　　处：《实用临床医药杂志》2011年第13期42-44,50,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨IVF新鲜周期中D3可用胚胎移植和冷冻后剩余胚胎继续培养的价值。方法通过囊胚序贯培养法将无原核（0PN）、单个原核（1PN）、多个原核（≥3PN）和卵裂期发育延缓的2原核（2PN）废弃胚胎培养至囊胚期。结果①314枚剩余胚胎于D5~D7形成152枚囊胚（48.41%）,其中53枚为优质囊胚（34.87%）;②胚胎级别越高,囊胚形成率越高（54.39%、52.39%、49.61%和21.62%）;③0PN和1PN卵裂发育而来的D3优质胚胎、2PN卵裂发育来的D3评分为Ⅲ级的胚胎囊胚形成率高于2PN卵裂发育来的D3评分〉Ⅲ级的囊胚形成率（P〈0.05）。结论 D3Ⅲ级以上胚胎仍有形成囊胚的机会;对于由0PN、1PN胚胎卵裂发育而来的D3优质胚胎可以继续培养,待形成囊胚后,行种植前遗传学诊断,如染色体核型为整倍体核型,可以冷冻或移植。以上措施可以提高患者单次取卵的累积妊娠率,也可以为胚胎干细胞研究提供资源。Objective To explore the developmental potential of the surplus embryos from human embryo transfer during IVF-ET cycles.Methods All embryos with non-pronucleus（0PN）,a single pronucleus（1PN）,a number of pronucleus（≥3PN） and 2 pronucleus delaying development in cleavage stage（2PN） were cultured into blastula by the sequential method.Results ① 314 Surplus embryos were collected and formed 152 blastulas（48.41%） after the sequential culture,among which 53（34.87%） were high-quality blastula.② The embryo grade on Day 3 was related to blastocyst rate.The higher embryo grade,the higher blastula formation（54.39%,52.39%,49.61% and 21.62%）;③ Blastocyst formation rates of embryos in 1PN embryos,0PN embryos and D3 from blastocyst embryos classified Ⅲ had higher rates of blastula formation than D3 from blastocyst embryos classified beyond Ⅲ（P0.05）.Conclusion Embryos of level Ⅲ and above in D3 are still opportunities for blastocyst formation.The 0PN,1PN embryo cleavage embryos developed from the D3 can continue to develop in high-quality,until after the formation of blastocysts,and then a pre-implantation genetic diagnosis.If the karyotype is aneuploid karyotype,then it should be frozen or transplanted first.The measures above can improve the oocyte retrieval in patients with accumulation of a single pregnancy,which can also provide resources for embryonic stem cell research.

关 键 词：剩余胚胎 异常受精 囊胚培养 胚胎干细胞 

分 类 号：R321[医药卫生—人体解剖和组织胚胎学]