论文部分内容阅读
目的:研究第2d(D2)胚胎核状态对D3胚胎质量和胚胎着床潜能的影响,以评估其在体外受精-胚胎移植(IVF-ET)中的临床应用价值。方法:回顾性分析本院生殖中心2006年7~10月的409例常规IVF-ET/ICSI移植周期的胚胎。评估D2胚胎卵裂球的核特征,将胚胎分为A级(胚胎的每个卵裂球内均可见单核)、B级(胚胎至少有1个卵裂球内未见核)和C级[胚胎至少有1个卵裂球内见多核(≥2个核)],比较各级胚胎的D3停滞胚胎率和优质胚胎率。并比较移植胚胎来自同一D2核类型的周期的临床妊娠率和着床率。结果:A级胚胎的D3停滞胚胎率低于B级和C级,优质胚胎率高于B级和C级(P<0.01)。B级胚胎的停滞胚胎率低于C级,优质胚胎率高于C级(P<0.01)。移植胚胎的D2核类型相同的周期共234例,其中移植胚胎均为A级胚胎的周期(A组)51例,移植胚胎均为B级胚胎的周期(B组)183例。A、B组间临床妊娠率差异无统计学意义(P>0.05),但A组的着床率高于B组(P<0.05)。结论:对D2胚胎进行核评估可预测胚胎的继续发育能力和着床潜能,将其与D3形态评估相结合,将有助于识别有活力的胚胎,减少移植胚胎数。
Objective: To investigate the effect of embryonic nucleus status on embryonic day 2 (D2) on D3 embryo quality and embryo implantation potential in order to assess its clinical value in IVF-ET (IVF-ET). Methods: A total of 409 routine IVF-ET / ICSI embryos in our hospital from July to October 2006 were retrospectively analyzed. The nuclear characteristics of D2 blastomere were evaluated. The embryos were divided into A class (single nucleus can be seen in each blastomere of embryos), B class (at least one nucleus of blastomeres was absent) and C class [See at least one blastomere in the embryo [Multicore nuclei (≥2 nuclei]]. Compare the stagnant embryos with D3 and embryos with good quality. And compare the clinical pregnancy rate and implantation rate of the transplanted embryos from the same D2 nuclear type cycle. Results: The embryo rate of D3 embryos was lower than that of B and C, and the rate of high quality embryos was higher than that of B and C (P <0.01). Grade B embryos had a lower rate of stagnated embryos than Grade C and higher quality embryos than Grade C (P <0.01). Transplanted embryos had the same type of D2 nucleus in 234 cases. All the embryos transferred were stage A (51 cases) and the embryos were all transferred to stage B (183 cases). There was no significant difference in clinical pregnancy rates between groups A and B (P> 0.05), but the implantation rate in group A was higher than that in group B (P <0.05). CONCLUSIONS: Nuclear assessment of D2 embryos predicts the ability of embryos to develop and implant, and combining them with morphometric assessment of D3 will help to identify viable embryos and reduce the number of embryos transferred.