时差成像技术在常规体外受精周期中单原核胚胎的原核形成和卵裂模式及对其发育潜能的应用  

Study of the pronucleus formation and cleavage pattern of embryos derived from mononuclear oocytes after conventional in-vitro fertilization by time-lapse imaging and evaluation of the developmental potential

作　　者：招霞[1] 王珊珊[1] 蒋益群[1] 张宁媛[1] 孙海翔[1] 

机构地区：[1]南京大学医学院附属鼓楼医院生殖医学中心,江苏南京210008

出　　处：《中国医药导报》2015年第32期74-78,82,共6页China Medical Herald

基　　金：江苏省省级条件建设与民生科技专项资金项目(BL2014003)

摘　　要：目的通过时差成像系统（TLI）观察常规体外受精-胚胎移植（IVF-ET）周期中单原核胚胎的发育特征,探讨原核形成方式、卵裂模式与囊胚形成的关系,评估单原核胚胎的发育潜能。方法选取2013年10月~2015年3月在南京鼓楼医院生殖医学中心行常规体外受精（IVF）周期患者的单原核胚胎的175个周期胚胎行TLI动态观察,对其中228个单原核胚胎进行囊胚培养,回顾性分析胚胎的原核形成方式、卵裂模式和囊胚形成结局。结果原核形成方式上,10.09%（23/228）的胚胎的单原核为2个原核融合而成,其他胚胎始终只观察到1个原核。卵裂模式上,21.93%（50/228）胚胎卵裂模式正常,异常的卵裂模式包括非轴性卵裂、不均卵裂、非二倍性卵裂、卵裂球碎裂、发育停滞及未卵裂,其中非二倍性卵裂和卵裂球碎裂较为多见,17.11%（39/228）单原核胚胎有可移植囊胚评分〉ⅣCC,7.46%（17/228）的胚胎形成的囊胚评分≥ⅣBB。原核形成方式上,2个原核融合为1个原核的单原核胚胎的可移植囊胚形成率显著高于始终为1个原核者;卵裂模式上,可移植囊胚均来源于卵裂模式正常及仅发生非轴性卵裂的胚胎,其可移植囊胚形成率分别为66.00%和46.15%,而其他卵裂模式异常的胚胎无可移植囊胚形成。结论常规IVF周期的单原核胚胎具有一定的发育潜能,单原核胚胎的发育潜能与其原核形成方式和卵裂模式密切相关,2个原核融合为1个原核的单原核胚胎和卵裂模式正常者及仅发生非轴性卵裂者具有较高的可移植囊胚形成率。当患者无可移植的双原核胚胎时,可将2个原核融合为1个原核的单原核胚胎纳入选择范围,卵裂模式亦有助于筛选具有发育潜能的单原核胚胎,对正常及仅发生非轴性卵裂的单原核胚胎进行移植或冷冻,以提高卵子利用率。Objective To observe the developmental characteristic of embryos derived from mononuclear oocytes after conventional in-vitro fertilization（IVF） by time-lapse imaging（TLI）, investigate the relationship of the pronucleus formation, the cleavage patterns and formation rates of blastocyst, and evaluate the developmental potential of mononuclear oocytes. Methods A retrospective study was performed to analyze the 228 mononuclear oocytes embryos of 175 conventional IVF treatment cycles using TLI from October 2013 to March 2015 in Reproductive Medicine Center of the Affiliated Drum Tower Hospital of Nanjing University Medical School. The pronucleus formation, cleavage patterns and blastocyst formation were analysed. Results There were 10.09%（23/228）embryos whose mononuclear were formed by the fusion of two pronuclei. The other embryos remained mononuclear throughout. 21.93%（50/228）embryos had normal cleavage pattern. The abnormal cleavage patterns included non-axial cleavage, uneven cleavage, non-diploid cleavage,fragmented blastomere, developmental arrest and no cleavage, among which non-axial cleavage and fragmented blastomere were more common. 17.11%（39/228）embryos derived from mononuclear oocytes formed good-quality（ⅣCC）, 7.46%（17/228）embryos formed blastocyst which grade reached or were greater than ⅣBB. The embryos whose mononuclear was formed by the fusion of two pronuclei have higher transferable blastocyst formation rates than the embryos remained mononuclear throughout. All the transferable blastocysts were developed from mononuclear oocytes with normal cleavage or non-axial cleavage, which the transferable blastocyst formation rates were 66.00% and 46.15% individually. Embryos with other abnormal cleavages had no transferable blastocyst formation. Conclusion Part of embryos after conventional IVF derived from mononuclear oocytes have the chance of forming blastocyst, the developmental potential is closely related to their pronucleus formation and cleavage patterns. Embryos whos

关 键 词：单原核胚胎 时差成像 原核形成 卵裂模式 体外受精 胚胎发育 

分 类 号：R329.1[医药卫生—人体解剖和组织胚胎学]