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目的探讨原核形态评分(原核评分)、卵裂胚发育与染色体异常的关系。方法2005年9月至2006年3月在广州医学院第三附属医院对需要行胚胎植入前诊断(PGD)的7例患者,于受精后第3天,应用荧光原位杂交(FISH)方法,选用13、18、21、X、Y5种染色体探针筛查这些病人种植前胚胎的非整倍体,同时分析原核评分、胚胎发育与染色体异常的关系。结果7例患者各行PGD1个周期,共获得73个胚胎;根据原核评分将所有胚胎分成A、B两组,原核评分≥14分的胚胎为A组,共49个;<14分者为B组,24个;在A组中,优质胚胎比例为46·9%(23/49),显著高于B组的20·8%(5/24),P<0·05;对52个胚胎进行活检,51个胚胎有FISH诊断结果;在有FISH诊断结果、原核评分≥14分的胚胎中,正常胚胎的比例为51·4%(19/37),显著高于评分<14分胚胎的21·4%(3/14),P<0·05;优质胚胎中,正常胚胎的比例为55·6%(15/27),显著高于非优质胚胎的29·2%(7/24),P<0·05。原核评分≥14分的优质胚胎中,染色体正常胚胎的比例为70·0%(14/20),高于优质胚胎的55·6%,但差异无统计学意义(P>0·05)。结论评分高的原核有更大的机会发育成优质胚胎和染色体正常的胚胎,优质胚胎中染色体正常胚胎的比例高于非优质胚胎。
Objective To investigate the relationship between prokaryotic morphological score (prokaryotic score), development of cleavage embryo and chromosomal abnormalities. Methods From September 2005 to March 2006, 7 patients who needed preimplantation diagnosis (PGD) at the Third Affiliated Hospital of Guangzhou Medical College were enrolled in this study. Fluorescence in situ hybridization (FISH) The 13, 18, 21, X and Y chromosome probes were used to screen the aneuploidy of preimplantation embryo in these patients. The relationship between prokaryotic score, embryo development and chromosomal abnormalities was also analyzed. Results All the 7 patients were PGD-1 cycles, and 73 embryos were obtained. All embryos were divided into A and B groups according to prokaryotic score, and 49 embryos with prokaryotic classification score ≥14 were grouped as group A , 24 in group B. In group A, the proportion of high quality embryos was 46.9% (23/49), which was significantly higher than that of group B (20.4%, P <0.05) The biopsy and FISH results of 51 embryos were confirmed. In embryos with FISH diagnosis and the prokaryotic score≥14, the percentage of normal embryos was 51.4% (19/37), significantly higher than 21 · 4% (3/14), P <0 · 05. The proportion of normal embryos was 55.6% (15/27) in normal embryos, which was significantly higher than that of non-high quality embryos (29.2% , P <0 · 05. The proportion of normal embryos with chromosomes ≥14 was 70.0% (14/20) higher than that of high quality embryos (55.6%), but the difference was not statistically significant (P> 0.05). Conclusion Higher prokaryotic nuclei have a greater chance of developing high quality embryos and normal chromosomes, and the proportion of normal embryos in high quality embryos is higher than in non-high quality embryos.