两种不同胚胎培养模式对体外胚胎发育和妊娠结局的影响  

Effect of different culture strategies of embryo cultured in vitro on embryo quality and pregnancy outcomes

作　　者：朱春芳[1] 葛红山[1] 陈华[1] 习海涛[1] 张帆[1] 黄检英[1] 吕杰强[1] 

机构地区：[1]温州医科大学附属第二医院生殖中心,温州325000

出　　处：《生殖与避孕》2015年第1期57-61,共5页Reproduction and Contraception

基　　金：国家自然科学基金项目(81370674);温州市科技局项目(Y20100205)

摘　　要：目的:比较2种胚胎培养模式对胚胎质量和妊娠结局的影响。方法:收集首次行IVF-ET治疗、年龄<38岁、采用长方案促排卵、常规IVF授精、正常受精卵数>3枚且第3日有新鲜胚胎移植的518个周期的临床资料,根据正常受精卵采用的培养模式分成单胚胎培养组(n=254)和胚胎群组培养组(n=264)。分析患者的基本资料、胚胎发育情况以及妊娠结局。结果:患者的年龄、不孕年限、基础卵泡刺激素(FSH)、Gn用量、h CG注射日内膜厚度以及各种不孕因素的比例等参数组间差异均无统计学意义(P>0.05);平均获卵数、成熟率、2PN率等指标组间也均无统计学差异(P>0.05),但胚胎群组培养组的卵裂率、第3日优质胚胎率、剩余胚胎可利用囊胚形成率均明显高于单胚胎培养组,差异有统计学意义(P<0.05);胚胎群组培养组的种植率和临床妊娠率高于单胚胎培养组,但差异无统计学意义(P>0.05)。结论:采用胚胎群组培养模式可以得到更多的优质胚胎和更高的囊胚形成率,推荐可用于日常IVF治疗周期中的胚胎培养。Objective： To compare the effect of two different embryo culture strategies on embryo quality and pregnancy outcomes. Methods： Clinical data about 518 first IVF cycles were collected. Patient＇s characteristics were summarized as age〈38 years, long protocol for ovulation, inseminated by classical IVF, more than 3 two-pronuclear （2PN） zygotes per cycle, and embryo transfer on day 3. After fertilization, 2PN zygotes of 254 cycles were cultured individually, the others were cultured in groups. The effect of different embryo culture strategies was studied. Results： There were no significant differences in the average age, infertility duration, basal FSH level, total dosage of gonadotropin, endometrial thickness on the day of hCG injection and the proportion of infertility factor between two different embryo culture groups （P〉0.05）. And mean number of oocytes retrieved, oocytes maturation rates, rates of 2PN were also similar （P〉0.05）. But group culture was superior in terms of cleavage rate, high-quality embryo rate of day 3 and blastocyst formation rate compared with individual culture （P〈0.05）. In addition, group culture showed a non-significant tendency for higher implantation rate and clinical pregnancy rate （P〉0.05）. Conclusion： This study provides an evidence that embryos cultured in group improves embryo development and blastocyst formation, group culture strategy can be recommended for routine IVF cycle.

关 键 词：培养模式 胚胎质量 单胚胎培养 胚胎群组培养 

分 类 号：R714.8[医药卫生—妇产科学]