囊胚培养及废弃胚胎临床研究  

Clinical research of blastocyst culture and discarded embryos

作　　者：梁鑫[1] 单旭东[1] 漆著[1] 贺贞[1] 谭欣[1] 吕自力[1] 朱明辉[1] 杨丹[1] 

机构地区：[1]成都中医药大学第二附属医院生殖医学中心,四川成都610041

出　　处：《中国妇幼保健》2015年第34期6103-6106,共4页Maternal and Child Health Care of China

基　　金：四川省教育厅项目〔14ZB0092〕;成都市科技项目〔2014-HM01-00187-SF〕;成都中医药大学科技发展基金〔ZRMS201344〕

摘　　要：目的 探讨囊胚培养在辅助生殖技术治疗周期中的价值以及质量较差胚胎和废弃胚胎的临床应用。方法 将受精后第3天（D3）卵裂期胚胎继续培养至囊胚。比较不同来源胚胎及不同卵裂球数和评分胚胎的囊胚形成情况,同时比较发育延缓胚胎受精后第4天（D4）冻融和囊胚冻融的结果,并利用囊胚形成情况对妊娠结局进行预测。结果 D3卵裂球数为6-9细胞且评分3分以上胚胎的优质囊胚形成率显著高于其他组（P〈0.01）。2个原核（2PN）胚胎的囊胚形成率和优质囊胚形成率均高于单原核（1PN）胚胎和无原核（0PN）胚胎（P〉0.05）。常规体外受精（IVF）和卵胞浆内精子注射（ICSI）胚胎进行比较,囊胚形成率和优质囊胚率无统计学差异（P〉0.05）。冻融囊胚的种植率和临床妊娠率均显著高于D4冻融胚胎（P〈0.01）。有囊胚形成者的种植率和临床妊娠率明显高于无囊胚形成者（P〈0.01）。结论 囊胚培养并冷冻保存具有极高的临床应用价值,且可间接预测妊娠结局。质量较差胚胎有一定的发育潜能,部分可发育为囊胚。Objective To explore the value of blastocyst culture in assisted reproductive technology treatment cycles and the clinical application of poor quality and discarded embryos. Methods The cleavage stage embryos on the third day after fertilization （D3） were cultured into blastocysts. Blastulation whose embryos were from different sources, had blastomere numbers and embryo quality classifications was compared, the frozen-thawed effects of delaying developmental embryos on the fourth day after fertilization （D4） and blastocyst were also compared, the pregnancy outcome was predicted based on blastulation. Results The formation rate of high-quality blastocysts whose D3 cleavage stage embryos had 6-9 cells and scored 3 or more than 3 was statistically significantly higher than those of other groups （ P〈0. 01 ）. The formation rates of blastocysts and high-quality blastocysts whose embryos had two pronucleus （2PN） were higher than those whose embryos had one pronucleus （1PN） and none （0PN） （P〉0. 05） . There was no statistically significant difference in the formation rates of blastocysts and high-quality blastocysts between conventional in vitro fertilization （IVF） embryos and intracytoplasmic sperm injection （ICSI） embryos （P〉0. 05 ） . The implantation rate and clinical pregnancy rate of frozen-thawed blastocysts were statistically significantly higher than those of D4 frozen-thawed embryos （ P〈0. 01 ） ; the implantation rate and clinical pregnancy rate of cases with blastulation were statisti- cally significantly higher than those of cases without blastulation （ P〈0. 01 ） . Conclusion Blastocyst culture and cryopreservation have high clinical application value, and it can indirectly predict pregnancy outcome. Poor-quality embryos have certain developmental potential, and some may develop into blastocysts.

关 键 词：辅助生殖技术 原核 卵裂期胚胎 囊胚 

分 类 号：R711.6[医药卫生—妇产科学]