目的探讨胚胎发育速度及形态评级并参考受精卵原核评级(联合评级),对行体外受精胚胎移植及卵母细胞质内单精子注射后移植胚胎筛选的意义。方法回顾性分析我院2003年5—12月,采用联合评级筛选进行胚胎移植的434个周期,共2714个正常受精卵的资料。根据受精卵原核发育是否同步,分为原核发育同步组和原核发育不同步组,观察不同原核等级受精卵的发育潜力;首先根据胚胎发育速度及形态评级,再根据受精卵原核等级的联合评级选择移植胚胎。根据移植胚胎中是否含有原核发育同步的胚胎,比较原核发育同步组与原核发育不同步组受精卵进行胚胎移植后的临床妊娠率和着床率。结果2714个正常受精卵中,原核发育同步组受精卵1774个,其中优质胚胎743个,优质胚胎率为41.88%;原核发育不同步组受精卵940个,其中优质胚胎319个,优质胚胎率为33.94%,两组比较,差异有统计学意义(P<0.01)。原核发育同步组中胚胎移植周期395个,临床妊娠率为47.85%(189/395),着床率为27.49%(273/993);原核发育不同步组中胚胎移植周期39个,临床妊娠率为43.59%(17/39),着床率为25.00%(21/84)。两组比较,差异无统计学意义(P>0.05)。结论采用联合评级,受精卵原核发育同步组与发育不同步组胚胎的临床妊娠率及着床率无差异;参考原核评级不能预测更高的妊娠率和着床率,但能预测胚胎发育的潜力。 OBJECTIVE: To investigate the rate of embryo development and its morphological grade, and to evaluate the effect of embryo transfer on the fertilization embryo transfer by in vitro fertilization embryo transfer and oocyte sperm injection by reference to the prokaryotic grading (combined grading). Methods A retrospective analysis of our hospital from May 2003 to December 2003, using a combined screening screening of 434 cycles of embryo transfer, a total of 2714 normal fertilized eggs. According to the synchronization of the pronucleus development of fertilized eggs, we divided them into prokaryotic development group and prokaryotic development non-synchronization group, and observed the developmental potential of different prokaryotic grade fertilized eggs. Firstly, according to embryo development speed and morphological grade, Transplant embryos. The clinical pregnancy rate and implantation rate after embryo transfer were compared between the prokaryotic synchronization group and the prokaryotic development non-synchronization group according to whether the embryo contains embryos with prokaryotic synchronization. Results Among the 2714 normal fertilized eggs, 1774 fertilized eggs were obtained in prokaryotic synchronization group, of which 743 were high quality embryos and 41.88% were high quality embryos. There were 940 fertilized eggs in asynchronous group, of which 319 were high quality embryos. The rate of high quality embryos was 33.94%, the difference between the two groups was statistically significant (P <0.01). There were 395 embryo transfer cycles in the prokaryotic synchronization group, the clinical pregnancy rate was 47.85% (189/395), the implantation rate was 27.49% (273/993); in the prokaryotic non-synchronization group, 39 embryo transfer cycles, clinical pregnancy rate Was 43.59% (17/39), the implantation rate was 25.00% (21/84). There was no significant difference between the two groups (P> 0.05). Conclusions There is no difference in the clinical pregnancy rate and implantation rate between embryos of pronucleus development group and developmental asynchronous group of fertilized eggs by joint grading. The reference to pronucleus rating can not predict higher pregnancy rate and implantation rate, but can predict the potential of embryo development .