胚胎形态学参数与整倍体状态的相关性分析  

Association between morphological parameters and ploidy status of the blastocysts

作　　者：申春艳[1] 张建瑞[1] 杜姗姗 刘艳丽[1] 管一春[1] 杨如镜[1] 王兴玲[1] Shen Chunyan;Zhang Jianrui;Du Shanshan;Liu Yanli;Guan Yichun;Yang Rujing;Wang Xingling(Reproductive Center of the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院生殖医学科,450052

出　　处：《中华生殖与避孕杂志》2021年第6期522-527,共6页Chinese Journal of Reproduction and Contraception

基　　金：河南省重点研发与推广专项(182102310408);河南省医学科技攻关计划项目(SB201902021)。

摘　　要：目的:研究胚胎植入前遗传学检测(preimplantation genetic testing, PGT)周期中,卵裂期(第3日)胚胎质量、囊胚活检时间、囊胚扩张程度、囊胚内细胞团(inner cell mass, ICM)评分及囊胚滋养层(trophectoderm,TE)评分对其整倍体状态的影响。方法:回顾性病例对照分析郑州大学第三附属医院生殖医学科2017年1月至2019年10月期间255个行PGT助孕周期的患者临床资料,分析囊胚相关形态学参数与整倍体状态的相关性。结果:①977枚囊胚进行活检,共937枚囊胚成功获得染色体结果(95.9%),其中整倍体396枚(42.3%),非整倍体541枚(57.7%)。②在夫妻双方有染色体异常的周期中,633枚囊胚整倍体率与女方年龄未呈现明显相关趋势,无染色体异常的周期中304枚囊胚整倍体率随着女方年龄的增加呈显著下降趋势( P=0.000 1)。③校正女方年龄及不同周期的影响后,第6日、第7日活检囊胚整倍体率显著低于第5日活检囊胚( OR=0.7, 95% CI=0.5~0.9, P=0.009 1;OR=0.4, 95% CI=0.1~0.6, P=0.001 2);ICM级别为B的活检囊胚整倍体率显著低于级别为A的囊胚 (OR=0.4, 95% CI=0.3~0.7 , P=0.000 1);TE级别为C的活检囊胚整倍体率显著低于级别为A的囊胚( OR=0.4, 95% CI=0.2~0.7, P=0.000 4)。但囊胚扩张程度及已经形成囊胚后第3日胚胎质量对囊胚整倍体率无显著影响。 结论:形成囊胚后第3日胚胎质量、囊胚扩张程度与囊胚整倍体状态无关,活检时间、ICM级别及TE级别与整倍体状态显著相关。Objective:To investigate the correlation between the human Day 3 embryo quality, blastocyst biopsy time, degree of expansion of the blastocysts, inner cell mass (ICM) morphology, trophectoderm (TE) morphology and their ploidy status.Methods:This was a retrospective case-control study for patients who underwent in vitro fertilization with preimplantation genetic testing (PGT) at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to October 2019. A total of 977 blastocysts were biopsied in 255 cycles of PGT, and the correlation between relevant morphological parameters and euploidy rate was analyzed. Results:① A total of 977 blastocysts from 255 cycles were biopsied, and 937 blastocysts (95.9%) successfully obtained chromosome results, including 396 (42.3%) euploidy and 541 (57.7%) aneuploidy. ② There was no significant correlation between the euploidy rate of blastocysts and the maternal age in the preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR) cycles (633 blastocysts), while in the preimplantation genetic testing for aneuploidy (PGT-A) cycles (304 blastocysts) the euploidy rate of blastocysts showed a significant downward trend with the increase of the maternal age ( P=0.000 1). ③ The euploidy rate of blastocysts biopsy on day 6 and day 7 was significantly lower than that on the day 5 ( OR=0.7, 95% CI=0.5-0.9, P=0.009 1;OR=0.4, 95% CI=0.1-0.6, P=0.001 2), the euploidy rate of the blastocysts with ICM grade B was significantly lower than that of the blastocysts with ICM grade A ( OR=0.4, 95% CI=0.3-0.7, P=0.000 1), the rate of euploidy of the blastocysts with TE grade C was significantly lower than that with TE grade A ( OR=0.4, 95% CI=0.2-0.7, P=0.000 4) adjusting for maternal age and cycle difference, while day 3 embryo quality, degree of expansion of the blastocysts were not associated with blastocysts ploidy. Conclusion:Day 3 embryo quality and expansion of the blastocysts have no correlation with euploidy, while

关 键 词：囊胚 整倍体 胚胎植入前遗传学检测 活检时间 

分 类 号：R714.8[医药卫生—妇产科学]