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D2胚胎核状态影响胚胎质量和着床潜能
引用本文:刘群,朱桂金,胡娟,魏玉兰,任新玲,章汉旺,李豫峰,靳镭,岳静. D2胚胎核状态影响胚胎质量和着床潜能[J]. 中华男科学杂志, 2008, 14(1): 26-29
作者姓名:刘群  朱桂金  胡娟  魏玉兰  任新玲  章汉旺  李豫峰  靳镭  岳静
作者单位:华中科技大学同济医学院附属同济医院妇产科,湖北,武汉,430030
摘    要:
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。

关 键 词:体外受精-胚胎移植  形态评估  胚胎质量  妊娠结局  单核卵裂球  多核卵裂球
文章编号:1009-3591(2008)01-0026-04
修稿时间:2007-04-12

Nuclear Status of Day 2 Preembryos Affects Embryo Quality and Implantation Potential
LIU Qun,ZHU Gui-jin,HU Juan,WEI Yu-lan,REN Xin-ling,ZHANG Han-wang,LI Yu-feng,JIN Lei,YUE Jing. Nuclear Status of Day 2 Preembryos Affects Embryo Quality and Implantation Potential[J]. National journal of andrology, 2008, 14(1): 26-29
Authors:LIU Qun  ZHU Gui-jin  HU Juan  WEI Yu-lan  REN Xin-ling  ZHANG Han-wang  LI Yu-feng  JIN Lei  YUE Jing
Affiliation:Department of Obstetrics and Gynecology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China. liuqun626@126.com
Abstract:
OBJECTIVE: To assess the effects of the nuclear status of day 2 preembryos on day 3 embryo quality and implantation potential and to weigh its clinical value in the human in-vitro fertilization-embryo transfer (IVF-ET) program. METHODS: Embryos obtained from 409 fresh conventional IVF-ET/ICSI cycles from July to October 2006 were assessed retrospectively. Day 2 preembryos were classified according to the number of nuclei in each blastomere in 3 groups: grade A with only mononucleated blastomeres, grade B with one or more blastomeres containing no visible nucleus, and grade C with one or more multinucleated blastomeres. Comparisons were made of the rates of arrested embryos and excellent embryos on day 3 as well as of the pregnancy outcome and implantation potential of those in whom cohorts of similar nuclear scoring embryos were transferred. RESULTS: There were fewer arrested embryos and more excellent embryos on day 3 in grade A than in grade B and C (P < 0.01), and so were there in grade B than in grade C (P < 0.01). Among the 234 cycles in which all the transfer embryos were derived from a similar day 2 nuclear scoring, 51 cycles originated from grade A embryos (group A) and 183 from grade B (group B), with similar clinical pregnancy rates between the two groups, while the implantation rate was higher in group A than in B (P < 0.05). CONCLUSION: Day 2 nuclear scoring can be used to predict the devel- opment and implantation potential of embryos. A combined evaluation of day 2 nuclear scoring and day 3 embryo morphology helps identify the most viable embryos and reduce the number of embryos for transfer.
Keywords:in vitro fertilization-embryo transfer  morphology scoring  embryo quality  pregnancy outcome  mononucleated blastomere  multinucleated blastomere
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