原核持续时间预测胚胎发育潜力的研究  

Study on prediction of embryonic development potential by pronuclear duration

作　　者：李柔 周静 廖宏庆 周俊 LI Rou;ZHOU Jing;LIAO Hong-qing;ZHOU Jun(The Second Affiliated Hospital,Hengyang Medical School,University of South China,Hengyang 421001;Hengyang Nanhua-Xinghui Reproductive Health Hospital,Hengyang 421001)

机构地区：[1]南华大学附属第二医院,衡阳421001 [2]衡阳南华星辉生殖健康专科医院,衡阳421001

出　　处：《生殖医学杂志》2022年第2期177-182,共6页Journal of Reproductive Medicine

摘　　要：目的使用时差培养箱观察比较不同原核持续时间的正常受精胚胎后续发育情况,探讨原核相关动力学参数对胚胎发育潜力的预测价值。方法对2018年9月至2021年1月在衡阳南华星辉生殖健康专科医院行时差成像系统观测的922枚正常受精来源胚胎的发育情况进行回顾性分析。根据原核持续时间的长短将胚胎分为≤15 h组(n=388)和>15 h组(n=534),比较两组胚胎的优质卵裂胚形成率、囊胚形成率、优质囊胚形成率及临床妊娠率;将行囊胚培养的764枚胚胎分为成囊组(n=558)与未成囊组(n=206),比较两组胚胎的原核持续时间;再根据不同授精方式和原核持续时间分为≤15 h IVF组(n=216)和>15 h IVF组(n=317)、≤15 h ICSI组(n=103)和>15 h ICSI组(n=128)4组,比较各组间胚胎的囊胚形成相关指标。结果以原核持续时间分组分析,>15 h组囊胚形成率(65.8%vs.83.1%)、优质囊胚形成率(35.7%vs.50.8%)和临床妊娠率(55.6%vs.79.6%)均较≤15 h组显著下降(P<0.05),而两组间优质卵裂胚形成率(55.4%vs.59.8%)无统计学差异(P>0.05)。未成囊组胚胎的原核持续时间较成囊组显著延长[(17.85±4.38)h vs.(15.61±2.75)h,P<0.05]。以授精方式+原核持续时间分组分析发现,>15 h IVF组囊胚形成率(68.8%vs.82.9%)、优质囊胚形成率(39.1%vs.50.0%)均较≤15 h IVF组显著下降(P<0.05);>15 h ICSI组囊胚形成率(58.6%vs.83.5%)、优质囊胚形成率(27.3%vs.52.4%)均较≤15 h ICSI组显著下降(P<0.05)。结论无论采用何种授精方式,原核持续时间≤15 h的胚胎囊胚形成率及囊胚质量均显著高于原核持续时间>15 h胚胎。原核持续时间对于胚胎发育潜力有一定的预测价值。Objective:To observe and compare the subsequent development of normal fertilized embryos with different pronuclear duration by using time-lapse incubator,and to explore the predictive value of pronuclear related kinetic parameters on embryo development potential.Methods:The development status of 922 normal fertilization embryos observed by time-lapse imaging system from September 2018 to January 2021 in Hengyang Nanhua-Xinghui Reproductive Health Hospital was retrospectively analyzed.The embryos were divided into two groups according to the length of pronuclear duration:≤15 hours group(n=388)and>15 hours group(n=534).The good-quality cleavage embryo formation rate,blastocyst formation rate,good-quality blastocyst formation rate and clinical pregnancy rate were compared between the two groups.The 764 embryos cultured were divided into the blastocyst formation group(n=558)and the non-blastocyst formation group(n=206).The pronuclear duration was compared between the two groups.According to different fertilization methods and pronuclear duration,the embryos were divided into four groups:≤15 hours IVF group(n=216),>15 hours IVF group(n=317),≤15 hours ICSI group(n=103)and>15 hours ICSI group(n=128),and indexes related blastocyst formation were compared among the groups.Results:In the different pronuclear duration groups,the blastocyst formation rate(65.8%vs.83.1%),good-quality blastocyst formation rate(35.7%vs.50.8%)and clinical pregnancy(55.6%vs.79.6%)in>15 hours group were significantly lower than≤15 hours group(P<0.05),while the good-quality cleavage embryo formation rate was not significantly different between two groups(55.4%vs.59.8%,P>0.05).The pronuclear duration of embryos in the non-blastocyst formation group was significantly longer than blastocyst formation group[(17.85±4.38)hours vs.(15.61±2.75)hours,P<0.05].In the different fertilization method and pronuclear duration gruops,the blastocyst formation rate(68.8%vs.82.9%)and good-quality blastocyst formation rate(39.1%vs.50.0%)in>15 hours IVF group

关 键 词：原核持续时间 囊胚形成 时差成像技术 发育潜力 

分 类 号：R711.6[医药卫生—妇产科学]