不同胚胎培养试剂胚胎发育时间动力学参数、胚胎发育潜能及临床结局的比较  

Comparison of embryonic development time kinetic parameters,embryo development potential and clinical outcomes of different embryo culture reagents

作　　者：金海霞[1] 王赛赛 石森林[1] 宋文妍[1] 刘艳[1] 闻爽[1] 吴瞾婷 Jin Haixia;Wang Saisai;Shi Senlin;Song Wenyan;Liu Yan;Wen Shuang;Wu Zhaoting(Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University,Henan Key Laboratory of Reproduction and Genetics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院生殖中心,河南省郑州大学第一附属医院生殖与遗传重点实验室,450052

出　　处：《中华生殖与避孕杂志》2020年第4期294-300,共7页Chinese Journal of Reproduction and Contraception

摘　　要：目的比较不同胚胎培养试剂对胚胎发育时间动力学参数、胚胎发育潜能及临床妊娠结局影响。方法回顾性分析2016年9月至2018年5月期间于郑州大学第一附属医院生殖医学中心行体外受精/卵胞质内单精子注射(IVF/ICSI)助孕患者资料,按照胚胎培养试剂不同,分为Vitrolife组和Cook组,比较符合入选标准的470个新鲜移植周期患者的胚胎时间动力学参数、胚胎发育潜能及临床妊娠结局。结果与Cook组比较,Vitrolife组原核出现时间、消失时间、发育到3-细胞和8-细胞时间更快[tPNa:(7.12±2.71)h比(7.40±2.61)h,tPNf:(23.83±4.33)h比(24.21±4.74)h,t3:(35.75±6.03)h比(36.64±6.16)h,t4:(38.30±6.25)h比(38.92±6.06)h,t5:(47.59±7.85)h比(49.01±7.86)h,t6:(50.77±7.17)h比(52.12±6.99)h,t7:(53.05±6.31)h比(54.33±6.37)h,t8:(55.35±6.89)h比(56.31±6.41)h],差异均有统计学意义(P均<0.05);细胞周期s2差异无统计学意义,在细胞周期同步性比较中,cc2[(9.71±4.60)h比(10.33±4.28)h]差异有统计学意义,Cook组具有更长的细胞周期,细胞发育时间间隔t5-t4[(10.60±5.65)h比(11.20±5.90)h]、t8-t4[(18.45±5.76)h比(19.28±5.18)h],差异均有统计学意义(P均<0.05),然而t2、t4-t2差异无统计学意义。两种胚胎培养试剂胚胎发育潜能比较显示,Cook组胚胎利用率(59.9%)、第3日(D3)优质胚胎率(65.4%)高于Vitrolife组(63.9%,P=0.017;69.5%,P=0.011);两组种植率、胚胎种植率、囊胚种植率、受精率、卵裂率差异均无统计学意义(P均>0.05);临床妊娠率、持续妊娠率、流产率、分娩率、活产率、胎儿畸形率、活产男女比例、胚胎妊娠率、囊胚妊娠率组间比较差异均无统计学意义(P均>0.05)。结论各中心应根据本中心的实际情况,摸索出适合本中心的胚胎培养试剂的胚胎时间动力学参数,制定符合最佳胚胎培养试剂选择标准,提高本中心患者临床妊娠率及活产率。Objective To compare the effects of two embryo culture reagents on embryonic developmental time dynamics,embryonic development potential and clinical pregnancy outcomes.Methods The data of patients undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)were retrospectively analyzed at the Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University from September 2016 to May 2018.According to the different embryo culture reagents,they were divided into Vitrolife group and Cook group,comparing the embryonic time dynamics parameters,embryo development potential and clinical pregnancy outcomes of 470 patients who met the criteria.Results There were significant differences in the kinetic parameters of embryo development between the two different embryo culture reagents.Compared with Cook group,Vitrolife group had shorter time in pronuclei appeare and disappear,and time of development to 3-cell and 8-cell embryos[tPNa:(7.12±2.71)h vs.(7.40±2.61)h,tPNf:(23.83±4.33)h vs.(24.21±4.74)h,t3:(35.75±6.03)h vs.(36.64±6.16)h,t4:(38.30±6.25)h vs.(38.92±6.06)h,t5:(47.59±7.85)h vs.(49.01±7.86)h,t6:(50.77±7.17)h vs.(52.12±6.99)h,t7:(53.05±6.31)h vs.(54.33±6.37)h,t8:(55.35±6.89)h vs.(56.31±6.41)h,all P<0.05].There was no significant difference in cell cycle s2 and had a significant difference in cc2[9.71±4.60)h vs.(10.33±4.28)h,P<0.001],synchronized in cell cycle in the sexual comparison.Cook group had a longer cell cycle,cell development time interval t5-t4[(10.60±5.65)h vs.(11.20±5.90)h],t8-t4[(18.45±5.76)h vs.(19.28±5.18)h]with statistically significant differences,all P<0.05,but there was no significant difference at t2 and t4-t2.Comparing the embryo development potential of the two embryo culture reagents,embryo utilization rate(59.9%vs.63.9%,P=0.017)and day 3(D3)high-quality embryo rate(65.4%vs.69.5%,P=0.011)in Cook group were higher than those in Vitrolife group.There were no significant differences in implantation rate,embryo implantation rate,blastocyst

关 键 词：延时成像 胚胎培养试剂 胚胎发育潜能 时间动力学 临床结局 

分 类 号：R714[医药卫生—妇产科学]