使用time-lapse筛选早期IVF/ICSI胚胎及其临床结局  

Embryo selection in IVF/ICSI cycles using time- lapse microscopy and the clinical outcomes

作　　者：陈明颢[1] 黄军[2] 钟影[2] 全松[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖医学中心,广东广州510515 [2]成都市锦江区妇幼保健院生殖医学中心,四川成都610016

出　　处：《南方医科大学学报》2015年第12期1760-1764,1781,共6页Journal of Southern Medical University

基　　金：四川省科学厅基础医学研究项目(2012JY0066)

摘　　要：目的通过比较使用time-lapse（延迟摄像）和传统形态学方法筛选IVF/ICSI胚胎的临床结局,评价time-lapse用于早期胚胎观察和筛选的价值。方法回顾性分析139个IVF/ICSI周期的资料,根据胚胎的筛选方法,分为time-lapse monitoring组（TLM组）（n=68）和对照组（n=71）,比较两组间的βHCG阳性率、临床妊娠率和胚胎着床率,并根据女方年龄、受精方式进行亚组分析。结果 TLM组的βHCG阳性率、临床妊娠率、胚胎着床率分别为：66.2%、61.8%、47.1%;对照组的βHCG阳性率、临床妊娠率、胚胎着床率分别为：47.9%、43.7%、30.3%;TLM组的βHCG阳性率、临床妊娠率、胚胎着床率均高于对照组,且差异均有统计学意义（P〈0.05）。亚组分析显示：相较于年龄≤30岁的患者,年龄31~35岁的患者利用time-lapse更能明显改善临床结局;利用time-lapse能明显提高IVF周期的βHCG阳性率、临床妊娠率、胚胎着床率,但对于ICSI和TESA周期,效果则不理想。结论使用time-lapse动态监测胚胎并根据胚胎的形态动力学参数对胚胎进行评价和筛选,与传统方法相比,能获得更好的临床结局;年龄较大的（〉30岁）或者是进行IVF周期的患者更能从中获益。Objective To compare the clinical outcomes of embryos selected using time- lapse microscopy and traditional morphological method in IVF/ICSI cycles and evaluate the clinical value of time-lapse microscopy in early embryo monitoring and selection. Methods We retrospectively analyzed the clinical data of 139 IVF/ICSI cycles with embryo selection based on time- lapse monitoring（TLM group, n=68） and traditional morphological method（control group, n=71）. The βHCG- positive rate, clinical pregnancy rate and embryo implantation rate were compared between the 2 groups. Subgroup analysis was performed in view of female patients＇ age and the fertilization type. Results The βHCG- positive rate, clinical pregnancy rate and implantation rate were 66.2%, 61.8% and 47.1% in TLM group, significantly higher than those in the control group（47.9%,43.7% and 30.3%, respectively; P〈0.05）. Compared with patients below 30 years of age, patients aged between 31 and 35 years benefited more from time-lapse monitoring with improved clinical outcomes. time-lapse monitoring significantly increased theβHCG- positive rate, clinical pregnancy rate and implantation rate for patients undergoing IVF cycles, but not for those undergoing ICSI or TESA cycles. Conclusion Compared with those selected using traditional morphological method, the embryos selected with time- lapse microscopy have better clinical outcomes, especially in older patients（31- 35 years of age）and in IVF cycles.

关 键 词：TIME-LAPSE 传统形态学方法 胚胎筛选 临床妊娠率 胚胎着床率 

分 类 号：R714.8[医药卫生—妇产科学]