时差成像系统对囊胚培养及妊娠结局的影响  

Influence of time-lapse imaging on blastocyst culture and pregnancy outcome

作　　者：高洋[1] 刘军霞[1] 朱家红 韩伟[1] 黄国宁[1] GAO Yang;LIU Jun-xia;ZHU Jia-hong;HAN Wei;HUANG Guo-ning(Chongqing Maternity Hospital,Chongqing Reproductive and Genetics Institute,Chongqing 400013)

机构地区：[1]重庆市妇幼保健院遗传与生殖研究所,重庆400013

出　　处：《生殖医学杂志》2020年第9期1198-1203,共6页Journal of Reproductive Medicine

基　　金：重庆市科卫联合医学科研项目(2017MSXM111);中华医学会临床医学科研专项基金(17020440713)。

摘　　要：目的探讨时差成像系统(TLI)对囊胚培养及妊娠结局的影响。方法选取2017年1月至2018年12月在本中心接受辅助生殖治疗并行囊胚培养的481例不孕患者为研究对象。根据囊胚培养方式不同分为采用TLI系统进行囊胚培养的TLI组(n=189)和采用传统培养体系培养囊胚的标准培养系统(SI)组(n=292),比较两组患者的一般资料及囊胚形成率、可利用囊胚率和优质囊胚率。TLI组采用形态学评分结合胚胎动态发育参数选择囊胚,SI组根据形态学评分选择囊胚,比较两组囊胚移植后的临床妊娠结局。结果两组患者的一般资料比较无显著性差异(P>0.05)。两组的受精率、2PN卵裂率、囊胚形成率、可利用囊胚率和优质囊胚率比较亦无显著性差异(P>0.05)。TLI组143例患者移植冻融囊胚,SI组217例移植冻融囊胚,两组的移植囊胚质量比较无显著性差异(P>0.05);但TLI组囊胚移植后的临床妊娠率(78.32%vs.68.66%)和着床率(65.63%vs.54.83%)显著高于SI组(P<0.05),两组的流产率比较无显著性差异(P>0.05)。结论采用TLI系统进行囊胚培养,以形态学评分结合胚胎动态发育参数选择囊胚,可以明显改善囊胚移植后的临床妊娠结局。Objective:To evaluate the effects of time-lapse imaging(TLI)on the blastocyst culture and pregnancy outcome.Methods:A total of 481 infertile patients who received assisted reproductive therapy and blastocyst culture were selected as the research subjects in our center from January 2017 to December 2018.According to the different culture methods of blastocyst,the patients were divided to two groups:the blastocysts were cultured by TLI in TLI group(n=189)and by traditional culture system in SI group(n=292).The general information,blastocyst formation rate,available blastocyst rate and high-quality blastocyst rate was compared between the two groups.The blastocysts were selected by morphological score combining with embryonic dynamic development parameters in the TLI group,and the blastocysts were selected according to the morphological score in the SI group.The clinical pregnancy rate,implantation rate and abortion rate after blastocyst transplantation were compared between two groups.Results:There were no significant differences in the general information,fertilization rate,2PN cleavage rate,blastocyst formation rate,available blastocyst rate and high-quality blastocyst rate between the two groups(P>0.05).Frozen-thawed blastocysts of 143 patients were transplanted in the TLI group,and 217 patients in the SI group.There was no significant difference in the transplanted blastocysts quality between the two groups(P>0.05).However,the clinical pregnancy rate(78.32%vs.68.66%)and implantation rate(65.63%vs.54.83%)after blastocyst transplantation in TLI group were significantly higher than those in SI group(P<0.05).There was no significant difference in abortion rates between the two groups(P>0.05).Conclusions:Usage of TLI system for blastocyst culture and selection embryos by morphological score combined with dynamic development parameters can significantly improve the clinical pregnancy outcome after blastocyst transplantation.

关 键 词：时差成像系统 囊胚培养 妊娠结局 辅助生殖 

分 类 号：R711.6[医药卫生—妇产科学]