非高龄患者囊胚整倍体率的形态学影响因素分析  

Analysis of morphologic affecting factors of blastocyst euploidy rate in non-elderly women

作　　者：李红星[1] 马晓玲[1] 景原雪[1] 宋德潇[1] 孙亮 曹頔 张欣怡 薛石龙[1] LI Hongxing;Ma Xiaoling;JING Yuanxue;SONG Dexiao;SUN Liang;CAO Di;ZHANG Xinyi;XUE Shilong(The First School of Clinical Medicine,The First Hospital of Lanzhou University,Key Laboratory for Reproductive Medicine and Embryo of Gansu Province,Lanzhou,Gansu Province,730000)

机构地区：[1]兰州大学第一临床医学院,兰州大学第一医院生殖医学中心,甘肃省生殖医学与胚胎重点实验室,730000

出　　处：《中国计划生育学杂志》2020年第11期1860-1863,共4页Chinese Journal of Family Planning

基　　金：甘肃省自然科学基金(18JR3RA350);兰州大学学生创新创业行动计划项目(20200060044);兰州大学第一医院院内青年基金项目(ldyyyn2018-11)。

摘　　要：目的:探讨非高龄患者囊胚整倍体率的形态学影响因素。方法:收集2018年1月—2019年7月在本院行胚胎植入前遗传学检测患者,超促排卵后胚胎培养至囊胚阶段,激光法活检4~8个囊胚滋养外胚层细胞,全基因组扩增后进行高通量测序和生物信息学数据分析。囊胚形态学评价参数包括囊胚分期、内细胞团和外滋养层评级等,分析胚胎的形态参数与整倍体发生率的关联。结果:活检402枚囊胚,成功获得396枚(98.5%)囊胚最终测序结果,其中整倍体囊胚190枚(47.9%),多因素分析结果表明相比于4期/5期囊胚和A/B级内细胞团,3期囊胚(OR=0.64,95%CI 0.44~0.92)和C级内细胞团(OR=0.34,95%CI 0.25~0.77)分别所对应囊胚整倍体率较低。结论:4期和5期囊胚的整倍体率较高;C级内细胞团的囊胚整倍体率较低(22.7%),需进行染色体检测后方可移植。Objective:To investigate the morphologic affecting factors of blastocyst euploidy rate of non-elderly women.Methods:Women who had experienced pre-implantation genetic testing were collected from January 2019 to April 2019.Blastocyst culture was performed after controlled ovarian hyperstimulation.4-8 trophoblastic ectodermal cells were obtained by laser biopsy.After whole genome amplification of these trophoblastic ectodermal cells,high-throughput sequencing and bioinformatics data analysis were carried out.The morphological parameters of blastocyst included blastocyst stage,and inner cell mass and external trophoblastic grading,etc.The relationship between morphological parameters and the blastocyst euploidy rate was analyzed.Results:A total of 402 blastocysts were biopsied and 396(98.5%)blastocysts were successfully sequenced,of which,190(47.9%)blastocysts were euploid.Multivariate analysis showed that stageⅢblastocyst(OR 0.64,95%CI 0.44-0.92)and C-grade inner cell mass(OR 0.34,95%CI 0.25-0.77)corresponded to the lower blastocyst aneuploidy rate when compared with stageⅣ/Ⅴblastocyst and A/B class inner cell mass.Conclusion:The stageⅣ/Ⅴblastocyst has higher euploidy rate,while the euploidy rate of blastocyst with C-grade inner cell mass is lower,which is 22.7%,so these blastocysts require chromosomal euploidy testing before they are transplanted.

关 键 词：胚胎植入前遗传学检测 囊胚形态学评级 染色体整倍体 

分 类 号：R714.8[医药卫生—妇产科学]