胚胎早期卵裂观察在胚胎发育潜能评估中的应用分析  

Application analysis on embryo development potential of early Cleavage Observation

作　　者：李超强[1] 蒋善芳[1] 吴亚敏[1] 伍春蓉[1] 

机构地区：[1]中山大学附属东华医院生殖中心,广东东莞523110

出　　处：《中国优生与遗传杂志》2015年第11期114-116,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨取卵后第一天(Day1)胚胎早期卵裂的观察在胚胎发育潜能及临床妊娠结局的预测价值。方法分析2013年5月至2014年4月179个常规IVF周期,依据受精后28±1h双原核(2pn)受精卵早期卵裂情况,分为早期卵裂组(A组)、pn消失未早期卵裂组(B组)、pn未消失未早期卵裂组(C组),比较每组优质胚胎率、可利用囊胚形成率和临床妊娠率等,其中移植结局又根据移植胚胎来源分4组,a组全移植早期卵裂来源胚胎、b组1个为早期卵裂来源胚胎、c组为pn消失未早期卵裂来源胚胎、d组为pn未消失未早期卵裂来源胚胎。结果 1.Day3评分A组、B组、C组的优质胚胎率(61.3%vs 53.1%vs32.1%),差异有统计学意义(P<0.05);胚胎可利用率为(72.2%vs 65.5%vs 39.1%),差异有统计学意义(P<0.05);可利用囊胚形成率(41.6%vs 37.9%vs 22.2%),差异有统计学意义(P<0.05)。2.早期卵裂细胞数为2且评分≤2级的胚胎形成优质胚胎率、可利用囊胚形成率均高于早期卵裂细胞数≥3或评分≥3级的胚胎,差异有统计学意义(P<0.05)。3.移植a组、b组、c组、d组的临床妊娠率为63.5%、48.3%、50.0%、44.6%,移植a组的临床妊娠率明显高于其它组别,但差异无统计学意义(P>0.05)。结论早期卵裂组的优质胚胎率、可利用囊胚形成率及胚胎移植结局明显高于非早期卵裂组,提示胚胎早期卵裂的观察有助于预测胚胎发育潜能,而早期卵裂细胞数为2且评分≤2级的胚胎发育潜能高。Objective：To investigate the value of the observation of embryo early cleavage on embryo development potential and clinical pregnancy outcome in the first day after take eggs（Day1）. Methods：From May 2013 to April 2014,179 conventional IVF cycles were analysed,according to the early cleavage of double pronucleus（2 pn）in 28±1h,divided into three groups,Group A：early cleavage,Group B：pn disappear without early cleavage,Group C：pn not disappear,compared the rate of each group of high quality embryos,the blastocyst formation rate and clinical pregnancy rate,etc.,and the transplant outcome according to the source of early cleavage or not,was divided into 4 groups,Group a：the whole from early cleavage,Group b：one from early cleavage,Group c：all from pn disappear without early cleavage,Group d：from pn existed. Results：1. The of quality embryo rate in Group A,Group B and Group C was 61.3%vs53.1%vs32.1% on Day3 score,which was statistically significant（P〈0.05）;the available embryo rate was 72.2% vs 65.5% vs 39.1%,which was statistically significant（P〈0.05）;the use of blastocyst rate was 41.6% vs 37.9% vs 22.2%,which was statistically significant（P〈0.05）. 2. Early cleavage of 2 cells with grade 2 was higher in the rate of good quality embryo and the available blastocyst than early cleavage with 3 or more cells,or score of 3 or more,which was statistically significant（P〈0.05）. 3. The clinical pregnancy rate of Group a,Group b,Group c and Group d was 63.5%,48.3%,50.0% and 44.6%,and clinical pregnancy rate of Group a was obviously higher than other groups,but there was no statistically significant difference（P 0.05）. Conclusions：The rate of good quality embryo,the available blastocyst and transplant outcome with early cleavage embryos was obviously higher than no early cleavage,which mean the observation of embryo early cleavage can predict potential of embryonic development,and early cleavage of 2 cells with grade 2is higher in the potential of embryonic development.

关 键 词：早期卵裂 胚胎发育潜能 妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]