不孕患者自身因素和胚胎形态学评价指标与囊胚形成关系的分析  

Correlative analysis of the infertility patients' condition and embryo morphology evaluation indicator with the blastocyst formation

作　　者：宋成 万才云 鲍忠剑 成金泉 黄菊 张宏展 曾勇 

机构地区：[1]深圳中山泌尿外科医院生殖医学中心深圳市围着床期生殖免疫重点实验室,深圳518000

出　　处：《中国优生与遗传杂志》2014年第2期114-116,共3页Chinese Journal of Birth Health & Heredity

基　　金：深圳市基础研究项目(编号:JCYJ20120829150019348)

摘　　要：目的探讨不孕患者自身因素以及体外培养Day3胚胎形态学指标与囊胚形成之间的相关性。方法将1894个体外受精-胚胎移植治疗周期的Day3移植后剩余的16 191个胚胎进行囊胚培养至Day6,分析女方年龄、不孕因素、体外受精方式、DAY3胚胎卵裂球数目以及碎片程度与囊胚形成的关系。结果女方年龄≤30岁组、31-35岁组和≥36岁组之间的囊胚形成率分别为31.38%(2315/7376)、29.42%(1773/6025)和22.15%(618/2790),并且组与组之间有统计学差异,P<0.05;不明原因不孕组的囊胚形成率26.41%(904/3423)低于排卵障碍组29.84%(588/1970)、盆腔输卵管组29.28%(2124/7255)、子宫内膜异位组30.26%(361/1193)和男方因素组31.02%(729/2350),且P<0.05;常规体外受精组的囊胚形成率29.25%(3234/11055)与卵胞浆单精子注射组27.69%(1472/5136)无统计学差异;DAY3卵裂球数目≥7个组、5-6个组和≤4个组的囊胚形成率分别为47.78%(1035/2166)、31.53%(2079/6594)和21.42%(1592/7431),并且组与组之间有统计学差异,P<0.05;DAY3碎片程度≤10%组、11-30%组和≥31%组的囊胚形成率分别为33.54%(2719/8106)、25.99%(1951/7507)和6.23%(36/578),并且组与组之间有统计学差异,P<0.05。结论女方年龄、不明原因不孕以及Day3胚胎形态学指标卵裂球数目和碎片程度都是影响囊胚形成的重要因素。在保证囊胚体外培养条件的基础上,综合评价患者自身条件以及胚胎发育情况,可以为临床合理运用囊胚培养方案提供依据。Objective： To investigate the relationship between the blastocyst formation and the infertility patients＇ condition and Day3 embryo morphology evaluation indicator in IVF - ET. Methods： All 16 191 surplus embryos after Day3 transfered were cultured to Day6 for the blastocyst formation in 1894 IVF cycles. We tried to find the relationship among the woman~ age, the infertility factors, the type of in vitro fertilization, the number of blastomere and the degree of fragmentation with blastocyst formation. Results ： The blas- tocyst formation rates of woman＇s age ≤ 30 years old group, the 31 -35 years old group and ≥ 36 years old group were 31.38% （2315/7376 ）, 29.42% （ 1773/6025 ） and 22. 15 % （618/2790） respectively, and there were significant differences among the three groups. The blastocyst formation rate of the unexplained infertility group （26.41%, 904/3423） was significantly less than the ovula- tion disorder group （29. 84%, 588/1970）, the pelvic cavity and fallopian tube group （29. 28%, 2124/7255 ）, the endometriosis group （30. 26%, 361/1193 ） and the male factors group （31.02%, 729/2350）. There was no significant difference between the blas- tocyst formation rates of the conventional fertilization group （29. 25%, 3234/11055 ） and the intracytoplasmic sperm injection group （27.69%, 1472/5136）. The blastocyst formation rates of the blastomere number t〉 7 group, 5 -6 group and ~〈 4 group in Day3 were 47.78% （1035/2166）, 31.53% （2079/6594） and 21.42% （1592/7431） respectively, and there were significant differences a- mong the three groups. The blastocyst formation rates of the fragmentation degree ~〈 10% group, 11 -30% group and I〉31% groups in Day3 were 33.54% （2719/8106）, 25.99% （1951/7507） and 6. 23% （36/578） respectively, and there were significant differ- ences among the three groups. Conclusion： The woman~ age, unexplained infertility, the number of blastomere and the degree of frag- mentation were important factors tha

关 键 词：不孕因素 胚胎形态学 囊胚形成 

分 类 号：R714.8[医药卫生—妇产科学]