辅助生殖技术中卵母细胞及卵裂期胞质空泡对胚胎生长发育的影响

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。

The influence of cytoplasmic vacuoles in oocytes and cleavage stage on embryonic development in assisted reproductive technology

Objective:To investigate the influence of cytoplasmic vacuoles in oocytes and cleavage stage on embryonic development in assisted reproductive technology.Methods:A retrospective study was conducted on patients undergoing IVF or ICSI from May 2010 to May 2011 in our center,469 women with at least one oocyte containing cytoplasmic vacuoles were enrolled.5 392 oocytes with normal morphology were as the normal group,510 oocytes which had vacuoles in cytoplasm were as the group of cytoplasmic vacuoles in oocytes.In this study,we also selected 559 oocytes with no vacuoles in oocyte stage but occurred spontaneously in cleavage stage as the group of in cleavage stage.Relatively good embryo rate and blastocyst formation rate in each group were compared.Results:Between the group of cytoplasmic vacuoles in oocytes and the normal group,the rates of good embryo(40.8%vs42.9%) and blastocyst formation(29.1%vs33.0%) were not significant different(P>0.05),but when the group of cytoplasmic vacuoles in oocytes compared with the group of vacuoles in cleavage stage(66.0%vs40.8%;36.7%vs29.1%),there was significant differences in the good embryo rate(P<0.001),but not in the blastocyst formation rate(P=0.066),10 patients were transplanted the embryos with cytoplasmic vacuoles,and 3 cases had single and 5 births at term.One of the newborns suffered from neonatal nypoxix-ischemic encephalopathy,but the remaining two cases had no obvious abnormalities.Conclusion:The cytoplasmic vacuoles in oocytes and the spontaneous vacuoles in cleavage stage may not affect embryo development,and can make a normal pregnancy and a viable offspring.