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目的:探讨辅助生殖技术中卵母细胞及卵裂期胞质空泡对早期胚胎发育及囊胚形成的影响。方法:回顾性分析行常规体外受精-胚胎移植(IVF-ET)或卵细胞胞质内单精子注射术(ICSI)治疗的有空泡异常形态发生的474个周期(共469例患者)共获卵8 324个,其中形态完全正常的MII卵母细胞共5 392个为胞质形态正常组,有空泡的卵母细胞共510个为卵母细胞胞质空泡组,同时该研究还发现了559个在卵母细胞期无空泡而在卵裂期出现空泡的胚胎作为卵裂期空泡组;比较各组间的优质胚胎率及可利用囊胚率。结果:卵母细胞胞质空泡组的优质胚胎率及可利用囊胚率均低于胞质形态正常组,但差异均无统计学意义(P>0.05);卵裂期空泡组的优质胚胎率及可利用囊胚率均高于卵母细胞胞质空泡组,但仅优质胚胎率差异有统计学意义(P<0.01),可利用囊胚率差异无统计学意义(P>0.05)。10例患者移植全部有卵母细胞胞质空泡的胚胎,其中3例单胎足月活产,1例患新生儿缺血缺氧性脑病,其余两名新生儿未见明显异常。结论:卵母细胞胞质空泡及卵裂期自发空泡的形成可能并不降低形成早期胚胎的质量及发育潜能,这些胚胎可以正常着床及足月活产。
Objective: To investigate the effects of oocyte and cleaved cytoplasmic vacuolization on early embryo development and blastula formation in assisted reproductive technology. Methods: A total of 474 cycles (469 patients) of abnormal morphogenetic status of vacuolar cells treated with routine in vitro fertilization-embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI) were retrospectively analyzed. 8 324, of which totally 3 392 MII oocytes with normal morphology were normal cytoplasm group, and 510 ones with vacuolar oocytes were oocyte cytoplasmic vacuole group. The study also found that 559 embryos with no vacuolization at the oocyte stage and vacuoles at the cleavage stage were used as the cleavage stage cleavage group. The rate of high quality embryos and available blastocyst rate were compared among the groups. Results: The quality embryo rate and available blastocyst rate of cytoplasmic vacuolysis group were lower than that of normal cytoplasm group, but the difference was not statistically significant (P> 0.05). The quality of cleavage phase vacuolization group Embryo rate and available blastocyst rate were higher than the oocyte cytoplasmic vacuolysis group, but only the quality of embryo rate difference was statistically significant (P <0.01), available blastocyst rate difference was not statistically significant (P> 0.05 ). All 10 patients were transplanted with oocyte cytoplasmic vacuolar embryos, of which 3 were singleton full-term live births, one with neonatal hypoxic-ischemic encephalopathy, and the other two neonates showed no abnormalities. CONCLUSIONS: The formation of oocyte vacuoles and spontaneous vacuoles at the cleavage stage of oocytes may not reduce the quality and developmental potential of early embryos. These embryos may be normal implantation and full-term live birth.