利用胚胎实时观测技术预测早期胚胎的发育潜能  

Predict developmental potential of early pre-implantation human embryo by time-lapse

作　　者：郑爱燕[1] 孟庆霞[1] 丁洁[1] 蒲艳[1] 廖桂芝 李红[1] 王玮[1] ZHENG Ai-yan;MENG Qing-xia;DING Jie;PU Yan;LIAO Gui-zhi;LI Hong;WANG Wei(Reproductive ＆ Genetic Center,Suzhou Municipal Hospital,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215002)

机构地区：[1]南京医科大学附属苏州医院,苏州市立医院生殖与遗传中心,苏州215002

出　　处：《生殖医学杂志》2018年第10期957-961,共5页Journal of Reproductive Medicine

基　　金：南京医科大学科技发展基金面上项目(2016NJMU147);江苏省妇幼保健科研项目(F201441);江苏省妇幼重点人才(FRC201725);江苏省苏州市临床医学中心项目(szzx201505)

摘　　要：目的探讨利用胚胎实时观测技术(Time-lapse)预测早期胚胎的发育结局的有效性。方法回顾性分析本中心2016年7月至2017年6月101例IVF Time-lapse周期,532枚行囊胚培养胚胎的早期发育时间点及胚胎发育的异常分裂行为。根据发育速度和发育质量分为三组:A组(D3细胞数≥6,且碎片≤20%的胚胎,共385枚)、B组(D3细胞数≥6,且碎片>20%的胚胎,共57枚)、C组(D3细胞数<6的胚胎,共90枚)。结果 (1)在A组,可用囊胚的2细胞至3细胞的持续时间(cc2)、3细胞至5细胞的持续时间(cc3)和发育至5细胞的时间(t5)显著高于废弃胚胎(P均<0.05),而3细胞至4细胞的持续时间(s2)、5细胞至8细胞的持续时间(s3)、发育至2细胞的时间(t2)、异常分裂(AC)和逆分裂(RC)显著低于废弃胚胎(P均<0.05),其余指标在可用囊胚与废弃胚胎间无显著性差异(P均>0.05);进一步,在可用囊胚中,优质囊胚的cc2、cc3、t5显著高于非优质囊胚(P均<0.05),s2、s3、AC和RC显著低于非优质囊胚(P均<0.05),其余指标在优质囊胚与非优质囊胚间无显著性差异(P均>0.05)。(2)在B组,除cc2外,其余指标在可用囊胚与废弃胚胎之间均无显著性差异(P均>0.05)。(3)在C组,所有指标在可用囊胚与废弃胚胎之间均无显著性差异(P均>0.05)。结论利用Time-lapse技术可以预测6细胞以上碎片少的形态学优质D3胚胎的发育潜能;而对于细胞数少或碎片多的形态学非优质D3胚胎,需扩大样本进一步研究。Objective： To explore ＂the effectiveness of using ＂time lapse to predict ＂the developmental outcome of early embryos. Methods： A retrospective analysis of 532 embryos with blastocyst culture from 101 IVF patients in our center from July 201G to June 2017 was performed. The morphological dynamics and abnormal cleavage events were observed. The embryos were divided into ＂three groups according to Day 3（D3）embryo quality, group A：D3 cells ≥6,fragment ≤20%（n=385） ; group B：D3 cells ≥6,fragment 〉20% （n=57）; group C：D3 cells 〈6（n=90）. Results： In group A,the duration of 2 cells to 3 cells of blastocysts（cc2）,the duration of 3 cells to 5 cells（cc3） ,and ＂the ＂time to development to 5 cells（t5）of available blastocysts were significantly higher ＂than ＂those of discarded embryos（P〈0.05） ,while ＂the duration of 3 cells to 4 cells（s2） ,＇the duration of 5 cells to 8 cells（s3） , the time to develop to 2 ceils （t2） , abnormal division （AC） , and reverse cleavage （RC） were significant lower than those of the discarded embryos （P〈0.05）; and the other indicators were not significantly different between available blastocysts and discarded embryos （P 〉 0.05）. Further, cc2, cc3, and t5 of high quality blastocysts were significantly higher ＂than low quality blastocysts（P〈0.05） ,and s2, s3,AC,and RC were significantly lower ＂than low quality blastocysts（P〈0.05） ; ＂the remaining indicators were not significantly different between high quality blastocysts and low quality blastocysts（P〉0.05）in available blastocysts. In group B, ＂there were no significant difference between available blastocysts and discard embryos（P〉0.05）, with ＂the exception of cc2 （P〈0.05）. And in group C, ＂there were also no significant difference between available blastocysts and discarded embryos（P〉0.05）. Conclusions： Time lapse technology can be used to predict the developmental potential of morphologically h

关 键 词：TIME-LAPSE 囊胚 形态动力学 异常分裂 

分 类 号：R714.8[医药卫生—妇产科学]