4B级以上D3胚胎囊胚形成影响因素分析  

Analysis of influencing factors for forming class Ⅳ above embryos on Day 3

作　　者：兖娜娜 杨菁[1] 徐望明[1] 龙文[1] 谢青贞[1] 苏红[1] 李风和[1] 罗金[1] 漆倩容 尹太郎[1] 

机构地区：[1]武汉大学人民医院生殖中心,武汉430061

出　　处：《生殖医学杂志》2017年第9期851-856,共6页Journal of Reproductive Medicine

基　　金：国家自然科学基金(81370767;81401276;81571513);湖北省卫生计生委基金项目(WJ2015MA006;WJ2015Q017)

摘　　要：目的探究4B级以上D3胚胎形成囊胚的能力差异,以及差异相关的影响因素分析。方法回顾性分析D3胚胎移植/冷冻后有剩余胚胎继续囊胚培养的949个IVF/ICSI-ET周期的临床资料及继续囊胚培养结局,根据继续囊胚培养的D3胚胎质量分为优质组(≥6B,507周期)和非优质组(4B^5B,442周期),比较两组的囊胚形成率、可利用囊胚形成率、优质囊胚形成率及其他临床和实验室影响因素。结果两组间患者基本资料及临床结局无统计学差异(P>0.05);与优质组相比,非优质组的囊胚形成率(31.44%vs.64.33%)、可利用囊胚形成率(20.36%vs.51.76%)、优质囊胚形成率(7.03%vs.25.93%)均显著降低,差异均有统计学意义(P<0.001);且优质组D5优质囊胚形成率显著高于非优质组(55.93%vs.26.36%,P<0.05);优质组D1 0原核(0PN)构成(17.89%vs.9.73%)、≤10%碎片构成(21.69%vs.9.73%)、胚胎不对称性(28.28%vs.14.95%)显著高于非优质组,而非优质组D1 2PN构成(83.87%vs.77.31%)、>20%碎片构成(34.59%vs.8.87%)显著高于优质组,差异均有统计学意义(P<0.001);在优质组中,年龄≤35岁者囊胚形成率、可利用囊胚形成率、优质囊胚形成率均显著高于年龄>35岁者(P<0.001),而非优质组未见年龄组间的统计学差异(P>0.05);与不对称胚胎相比,优质组对称胚胎的囊胚形成率(68.03%vs.54.95%)、可利用囊胚形成率(55.42%vs.42.49%)、优质囊胚形成率(28.98%vs.18.19%)均显著增加,差异均有统计学意义(P<0.001)。结论不同质量的D3胚胎有不同的发育能力,女方年龄、D1PN构成、D3胚胎碎片率、胚胎不对称性均影响可利用囊胚及优质囊胚的形成,优质胚胎形成囊胚较快(D5),非优质囊胚形成囊胚较晚(D6)。Objective： To analyze the factors affecting the formation of class 4B above embryos on Day 3.Methods： The clinical data and the outcome of 949IVF/ICSI-ET cycles in which the remaining embryos continued to be cultured after transferring/freezing Day 3embryo were analyzed.The cycles were divided into two groups：top quality embryo（≥6B）group（507cycles）and non-top quality embryo（4B-5B）group（442 cycles）according to the quality of Day3 embryos.The blastulation rate,available blastulation rate,high quality blastulation rate and other clinical and lab factors were compared between the two groups.Results：There were no significant differences of clinical data and pregnancy outcomes between the two groups（P〉0.05）.The blastulation rate（31.44%vs.64.33%）,available blastulation rate（20.36%vs.51.76%）,high quality blastulation rate（7.03%vs.25.93%）in the non-top quality embryo group was significantly lower than that of the top quality embryo group（P〈0.001）.The rate of blastulation on Day 5in top quality embryo group（55.93%vs.26.36%）was significantly higher than that in non-top quality embryo group（P〈0.05）.The constituent ratio of Day1 0PN（17.89%vs.9.73%）,fragment≤10%（21.69%vs.9.73%）and embryo asymmetry（28.28%vs.14.95%）in top quality embryo group were significantly higher than that of non-top quality embryo group（P〈0.001）.And the constituent ratio of D12PN（83.87%vs.77.31%）,fragment20%（34.59%vs.8.87%）in non-top quality embryo group were significantly higher than that in top quality embryo group（P〈0.001）.In the top quality embryo group,the blastulation rate,available blastulation rate,and high quality blastulation rate in≤35years group were significantly higher than those in〉35years group（P〈0.001）,but there were no significant differences in the non-top quality embryo group（P〉0.05）.In the top quality embryo group,the rate of blastulation（68.03%vs.54.95%）,available blastulation（55.42%vs.42.49%）,high quality blastulation

关 键 词：D3胚胎 囊胚形成 优质囊胚形成 影响因素 

分 类 号：R[医药卫生]