囊胚发育速度和形态学参数与整倍体状态及妊娠结局的相关性  

Correlation of speed of blastocyst development and morphological parameters with embryo euploidy and pregnancy outcomes

作　　者：陈梦茜 王莹[1] 周林[1] 曹善仁[1] 武恂[1] 凌秀凤[1] 张军强[1] CHEN Mengxi;WANG Ying;ZHOU Lin;CAO Shanren;WU Xun;LING Xiufeng;ZHANG Junqiang(Center of Reproductive Medicine, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing Jiangsu 210004, China)

机构地区：[1]南京医科大学附属妇产医院生殖医学中心,江苏南京210004

出　　处：《江苏大学学报（医学版）》2022年第2期141-145,151,共6页Journal of Jiangsu University：Medicine Edition

基　　金：国家自然科学基金面上项目(81871210);南京医科大学科技发展基金资助项目(NMUB2019226)。

摘　　要：目的:研究胚胎植入前遗传学检测周期中,囊胚发育速度、囊胚扩张程度、内细胞团等级和滋养层细胞等级对其整倍体状态及整倍体胚胎移植后妊娠结局的影响。方法:回顾性分析2017年10月至2021年1月南京医科大学附属妇产医院生殖医学中心行胚胎植入前非整倍体遗传学检测(preimplantation genetic testing for aneuploidy,PGT-A)助孕的237个活检周期及127个复苏移植周期,分析胚胎发育速度和形态学特征与整倍体检测结果及妊娠结局的关系。结果:①纳入分析的237个活检周期中,共成功检测975枚囊胚,其中整倍体囊胚为479枚(49.13%),非整倍体囊胚为496枚(50.87%);②考虑校正因素后,第6、7天形成的囊胚较第5天整倍体率显著降低(OR=0.640,95%CI:0.493~0.830,P=0.001);囊胚内细胞团B级别整倍体率较A级别显著降低(OR=0.235,95%CI:0.123~0.449,P<0.001);囊胚滋养层C级别整倍体率较A级别显著降低(OR=0.360,95%CI:0.192~0.674,P=0.001);囊胚扩张程度与整倍体状态无关;③校正年龄前后,不同的囊胚形成时间、囊胚扩张程度、内细胞团级别、滋养层细胞等级之间临床妊娠率均未见差异。结论:PGT-A周期中,囊胚形成时间、内细胞团等级、滋养层细胞等级与整倍体状态显著相关,囊胚扩张程度与整倍体状态无关;囊胚发育速度、内细胞团等级、滋养层细胞等级及囊胚扩张程度均与整倍体胚胎复苏移植周期早期妊娠结局无相关性。Objective:To investigate the correlation among the blastocyst development speed,the degree of blastocyst expansion,the level of inner cell mass,and the level of trophoblast cells and their euploidy status and pregnancy outcomes in preimplantation genetic testing cycles.Methods:A total of 237 preimplantation genetic testing for aneuploidy(PGT-A)cycles and 127 resuscitation transplant cycles from October 2017 to January 2021 in the Center of Reproductive Medicine,Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University were included in the study.The relationship among embryo development speed and morphological characteristics,euploidy and pregnancy outcome was analyzed.Results:①In 237 biopsy cycles included for analysis,975 blastocysts were successfully detected,including 479 euploid blastocysts(49.13%)and 496 aneuploid blastocysts(50.87%).②After considering the correction factors,the euploid rate of blastocysts on the 6th and 7th day was significantly lower than that on the 5th day(OR=0.640,95%CI:0.493~0.830,P=0.001).The euploidy rate of cell masses in blastocyst grade B was significantly lower than that in grade A(OR=0.235,95%CI:0.123-0.449,P<0.001);the euploidy rate of blastocyst trophoblast of grade C was significantly lower than that of biopsy blastocyst of grade A(OR=0.360,95%CI:0.192-0.674,P=0.001).The degree of blastocyst expansion has no association with the euploid state.③Before and after age correction,there were no difference in clinical pregnancy rate between blastocyst formation time group,blastocyst expansion degree group,inner cell grade group and trophoblast cell group.Conclusion:In PGT-A cycles,the blastocyst development rate,the grade of inner cell mass and the grade of trophoblast cells were significantly correlated with the status of euploidy,while the degree of blastocyst expansion was not correlated with the status of euploidy.There was no correlation between the early pregnancy outcomes of euploidy embryo transfer cycles and the time of blastocyst formation,the grade

关 键 词：胚胎植入前遗传学检测 囊胚 整倍体 囊胚发育速度 胚胎移植 妊娠结局 

分 类 号：R714[医药卫生—妇产科学] R715[医药卫生—临床医学]