早期异常卵裂不影响囊胚染色体整倍性  

Early abnormal cleavage does not affect the chromosome aneuploidy of blastocysts

作　　者：王江 熊顺[1,2] 韩伟 付涛[1,2] 魏彪 梁延峰 邹佳益 黄国宁 WANG Jiang;XIONG Shun;HAN Wei;FU Tao;WEI Biao;LIANG Yan-feng;ZOU Jia-yi;HUANG Guo-ning(Reproductive Medicine Center,Chongqing Health Center for Women&Children,Chongqing 400013;Chongqing Key Laboratory of Human Embryo Engineering,Chongqing 400013)

机构地区：[1]重庆市妇幼保健院生殖医学中心,重庆400013 [2]人类胚胎工程重庆市重点实验室,重庆400013

出　　处：《生殖医学杂志》2021年第9期1146-1151,共6页Journal of Reproductive Medicine

基　　金：重庆市卫生局科研项目(2020MSXM086)。

摘　　要：目的分析囊胚早期异常卵裂与整倍性的关系,探讨异常卵裂胚胎的临床应用价值。方法回顾性分析2020年于重庆市妇幼保健院生殖医学中心接受植入前遗传学检测(PGT)治疗的患者资料。采用延时成像技术监测胚胎卵裂模式并依据卵裂模式将活检囊胚分为正常卵裂、异常卵裂;异常卵裂中,直接卵裂又分为快速直接卵裂、多极直接卵裂。分析比较不同卵裂模式囊胚的整倍性及临床结局。结果收集了993枚有效活检胚胎相关信息,其中83.18%(826/993)活检囊胚早期卵裂正常,16.82%(167/993)活检囊胚早期卵裂异常。正常卵裂和异常卵裂囊胚的整倍体率无统计学差异(38.14%vs.44.31%,P=0.25);异常卵裂囊胚中快速直接卵裂、多极直接卵裂的构成比分别是52.10%(87/167)、24.55%(41/167),两种直接卵裂囊胚的整倍性也无统计学差异(45.98%vs.43.90%,P=0.88)。与正常卵裂囊胚比较,异常卵裂整倍体囊胚解冻移植后临床妊娠率、流产率未见显著差异(P>0.05)。结论早期异常卵裂不影响囊胚整倍体率及发育潜能。因此异常卵裂胚胎可行囊胚培养后应用,提高其临床价值。Objective:To analyze the relationship between early abnormal cleavage and chromosomal aneuploidy in blastocysts,and explore clinical application potential of blastocysts with abnormal cleavage.Methods:The data of patients who underwent preimplantation genetic testing(PGT)in Chongqing Health Center for Women&Children in 2020 was retrospectively analyzed.Time-lapse imaging was applied to monitor embryo cleavage pattern.According to embryo cleavage pattern,the blastocysts were divided into normal and abnormal cleavage group.In the abnormal cleavage group,the direct cleavage was subdivided into rapid direct cleavage and multipolar direct cleavage.The euploidy of blastocysts with different cleavage patterns and clinical outcome were compared among the groups.Results:The data of 993 blastocysts were effectively collected.Among them,83.18%(826/993)of blastocysts had normal cleavage and 16.82%(167/993)had abnormal cleavage.The euploid rate of blastocysts was not significantly different between normal and abnormal cleavage group(38.14%vs.44.31%,P=0.25).In the abnormal cleavage blastocysts,the percentages of rapid direct cleavage and multipolar direct cleavage were 52.10%(87/167)and 24.55%(41/167),respectively.And there was no significant difference in euploid rates between the two kinds of direct cleavage blastocysts(45.98%vs.43.90%,P=0.88).No significant difference was found in clinical pregnancy rate and miscarriage rate after thawing and transplantation of blastocysts between normal cleavage and abnormal cleavage blastocysts(P>0.05).Conclusions:Early abnormal cleavage did not affect the rate of blastocyst aneuploidy and developmental potential.Therefore,abnormal cleavage embryo can be used after blastocyst culture to improve its clinical value.

关 键 词：延时摄像 植入前遗传学检测 卵裂模式 整倍体 

分 类 号：R711.6[医药卫生—妇产科学]