培养液对胚胎早期发育动态表型和动力学参数的影响:一项time-lapse研究  

Effects of culture media on early developmental dynamic phenotypes and kinetic parameters of embryos:a time-lapse study

作　　者：毛献宝[1] 王世凯[1] 谭卫红[1] 成俊萍[1] 李政达 覃捷[1] 张小慧[1] 韦娉嫔 薛林涛[1] Mao Xianbao;Wang Shikai;Tan Weihong;Cheng Junping;Li Zhengda;Qin Jie;Zhang Xiaohui;Wei Pingpin;Xue Lintao(Center for Reproductive Medicine and Genetics,People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院生殖医学与遗传中心,南宁530021

出　　处：《中华生殖与避孕杂志》2022年第1期50-57,共8页Chinese Journal of Reproduction and Contraception

基　　金：广西自然科学基金(2018GXNSFAA138112,2019GXNSFAA185056);广西重点研发计划(桂科AB18050024);广西卫健委科研课题(Z20180742);南宁市青秀区重点研发计划(2018025);广西壮族自治区人民医院青年基金(QN2019-1)。

摘　　要：目的探讨胚胎早期发育动态表型和动力学参数是否受培养液组分差异的影响。方法回顾性队列研究分析广西壮族自治区人民医院生殖医学与遗传中心2016年10月至2018年12月期间收治的体外受精(in vitro fertilization,IVF)周期患者的临床资料,根据使用的培养液品牌不同,将IVF周期分为Cook组和Vitrolife组,经1∶1倾向性评分匹配后,每组纳入59个,采用延时成像技术分析正常受精卵裂胚胎授精后68 h内的早期发育形态动力学。记录胚胎发育动态表型,比较两组胚胎7种发育动态表型构成的差异;计算正常表型胚胎的13个早期发育动力学参数,比较两组之间动力学参数的差异;基于两个已发表的time-lapse胚胎筛选模型,比较两组正常动态表型胚胎的等级分布差异。结果①Cook组胚胎发育动态表型构成如下:正常表型54.0%、胞质异常波动(abnormal first cytokinesis,A1^(cyt))3.0%、不规则卵裂(abnormal cleavage,AC)17.4%、逆向卵裂(reverse cleavage,RC)5.2%、无序卵裂(chaotic cleavage,CC)3.2%、多核(multinucleation,Mn)3.5%以及混合表型13.7%;Vitrolife组胚胎发育动态表型构成如下:正常表型49.3%、A1^(cyt) 4.0%、AC 19.1%、RC 7.5%、CC 2.1%、Mn 6.4%以及混合表型11.6%,两组间表型构成差异没有统计学意义(P>0.05)。②相较于Vitrolife组,Cook组正常动态表型胚胎13个发育动力学参数(tPNa、tPNf、t2、t3、t4、t5、t6、t7、t8、cc2、s2、t5_PNf和t8_PNf)均略长,授精后68 h胚胎平均卵裂球数略少,但差异均无统计学意义(均P>0.05)。③基于模型A,Vitrolife组与Cook组胚胎等级分布差异没有统计学意义(P>0.05);基于模型B,两组胚胎等级分布差异存在统计学意义(P=0.040),其中Vitrolife组A+级胚胎比例较Cook组高[59.8%(125/209)比43.3%(94/217)],而C级胚胎比例较Cook组低[9.6%(20/209)比20.3%(44/217)]。结论胚胎早期发育动态表型及动力学参数不受Cook与Vitrolife序贯培养液差异的影响,但不同tObjective To investigate whether the early developmental dynamic phenotypes and kinetic parameters of embryos used for embryo selection are affected by the differences in the components of culture media utilized.Methods The clinical data of patients undergoing in vitro fertilization(IVF)at Center for Reproductive Medicine and Genetics of People's Hospital of Guangxi Zhuang Autonomous Region from October 2016 to December 2018 were analyzed in a retrospective cohort study.According to the different culture media utilized,IVF cycles were divided into Cook group and Vitrolife group.After 1∶1 propensity-score matching(PSM),59 IVF cycles were included in each group.Time-lapse imaging technology was used to analyze the early developmental dynamics of normal fertilized embryos between insemination and 68 h post insemination.Seven developmental dynamic phenotypes of embryos were annotated and the differences in the composition of dynamic phenotypes were compared between the two groups.Thirteen early developmental kinetic parameters were calculated,and the differences in the kinetic parameters of normal dynamic phenotypic embryos between the two groups were compared.According to the two published time-lapse embryo selection algorithms,the hierarchical distribution of normal dynamic phenotypic embryos of two groups was compared.Results 1)In Cook group,the composition of developmental dynamic phenotypes of embryos were 54.0%normal phenotype,3.0%abnormal first cytokinesis(A1^(cyt)),17.4%abnormal cleavage(AC),5.2%reverse cleavage(RC),3.2%chaotic cleavage(CC),3.5%multinucleation(Mn)and 13.7%mixed phenotype,which were 49.3%,4.0%,19.1%,7.5%,2.1%,6.4%and 11.6%in Vitrolife group,respectively.No statistically significant differences were observed between the two groups for the composition of dynamic developmental phenotypes(P>0.05).2)Compared with Vitrolife group,the 13 developmental kinetic parameters(tPNa,tPNf,t2,t3,t4,t5,t6,t7,t8,cc2,s2,t5_PNf and t8_PNf)of normal dynamic phenotype embryos in Cook group were slightly longer,and

关 键 词：培养基 延时成像 胚胎动力学 动态表型 胚胎评估 

分 类 号：R714.8[医药卫生—妇产科学]