时差成像系统在选择高发育潜能未成熟卵母细胞体外成熟受精胚胎中的应用  

Application of time-lapse imaging in selecting embryos with high developmental potential from ummature oocytes after in vitro maturation

作　　者：狄春光 王丽萍[1] 王慧[1] 王功发 王毅 朱琴[1] DI Chunguang;WANG Liping;WANG Hui;WANG Gongfa;WANG Yi;ZHU Qin(Center for Reproductive Medicine,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市妇幼保健院生殖中心,314000

出　　处：《浙江医学》2020年第18期1927-1930,共4页Zhejiang Medical Journal

基　　金：嘉兴市科技计划项目(2016AY23068)。

摘　　要：目的探讨时差成像系统(TLI)在选择高发育潜能未成熟卵母细胞体外成熟(IVM)受精胚胎中的应用价值。方法收集2016年2月至2019年5月于嘉兴市妇幼保健院接受体外受精-胚胎移植治疗患者的525枚未成熟卵母细胞进行IVM,同时收集周期中正常成熟卵细胞207枚。IVM后成熟卵母细胞及正常成熟卵母细胞均行卵细胞浆内单精子注射(ICSI),受精后胚胎在TLI中观测培养。收集所有胚胎发育的时间参数,用四分位数法和logistic回归法分析前期收集的402枚未成熟卵母细胞IVM受精胚胎(IVM胚胎)的时间参数与囊胚形成的关系,得出TLI在选择高发育潜能IVM胚胎中的应用价值,并用后期收集的123枚未成熟卵母细胞形成的IVM胚胎时间参数与囊胚形成率的关系进行验证。结果IVM胚胎D3可利用胚胎率、D3优胚率、囊胚形成率均低于正常卵母细胞受精胚胎(正常胚胎)(均P<0.05),非二倍性卵裂率大于正常胚胎(P<0.05)。经四分位数法和logistic回归分析发现IVM胚胎发育至5细胞的时间(t5)在时间段(37.50~52.68)h内对形成囊胚最有预测价值。用后期收集的123枚未成熟卵母细胞形成的IVM胚胎时间参数与囊胚形成率的关系验证t5的预测价值,发现t5优势时间段内囊胚形成率为60.0%,显著高于非t5优势时间段内的囊胚形成率(14.3%,P<0.05)。结论TLI可以作为选择高发育潜能IVM胚胎的有效工具。Objective To explore the application of time-lapse imaging system(TLI)in selection of embryos with high developmental potential from immature oocytes after in vitro maturation(IVM).Methods A total of 525 immature oocytes were collected for IVM,and 207 normal mature oocytes were also collected in our center from February 2016 to may 2019.Intracytoplasmic sperm injection(ICSI)were performed on immature oocytes after IVM and normal mature oocytes.After fertilization,embryos were observed and cultured in TLI.The relationship between the time parameters of 402 embryos fertilized from immature oocytes after IVM(IVM embryos)and blastocyst formation was analyzed by quartile method and logistic regression method.The application value of TLI in the selection of IVM embryos with high developmental potential was examined.The relationship between the time parameters of IVM embryos and blastocyst formation rate was verified in other 123 immature oocytes receiving IVM.Results D3 available embryo rate,D3 good embryo rate,blastocyst formation rate of IVMembryos were lower than those of conventional in vitro fertilized embryo(all P<0.05),and the time of development to 5 cell phase(t5)within 37.50-52.68 h was the most valuable predictors of blastocyst formation,which was verified in 123 immature oocytes undergoing IVM.The blastocyst formation rate in t5 dominant period(37.50-52.68 h)was 60.0%,which was significantly higher than that in non-t5 dominant period(14.3%)(P<0.05).Conclusion TLI technique can be used as an effective tool for selecting high developmental potential embryos fertilized fromoocytes after IVM.

关 键 词：时差成像 未成熟卵母细胞体外成熟 时间参数 体外受精 胚胎发育 

分 类 号：R714.8[医药卫生—妇产科学]