序贯培养体系和单一培养体系对人卵母细胞受精和早期胚胎发育的影响

目的：比较在体外受精/卵胞质内单精子显微注射（IVF/ICSI）治疗周期中序贯培养体系和单一培养体系对人类早期胚胎发育的影响，为人类辅助生殖技术中胚胎培养体系的选择和评估提供参考。方法：选取155例行IVF/ICSI助孕的患者，将同一个患者的卵子分为2组，分别在Vitrolife的序贯培养体系G-IVF/G1/G2培养液（序贯培养组）和Irvine的单一培养体系CSCC培养液（单一培养组）中进行体外受精和胚胎培养，观察2组不同培养体系中胚胎受精和胚胎早期发育情况。结果：与单一培养组比较，序贯培养组受精率、双原核（2PN）受精率和多核受精率差异均无统计学意义（P>0.05）。在IVF患者中，序贯培养组和单一培养组的卵裂率、可用胚胎率、优质胚胎率和囊胚形成率比较差异均无统计学意义（P>0.05）；在ICSI患者中，序贯培养组和单一培养组的卵裂率、可用胚胎率和囊胚形成率比较差异均无统计学意义（P>0.05），但序贯培养组优质胚胎率明显高于单一培养组（P=0.015）。在IVF和ICSI患者中，单一培养组第3天胚胎致密化的比例均明显高于序贯培养组（P=0.001）。在序贯培养组中胚胎形态表面光滑均匀，单一培养组中胚胎表面较为粗糙且有颗粒状。结论：G-IVF/G1/G2序贯培养体系和CSCC单一培养体系对人卵母细胞受精和早期胚胎发育的影响无明显差异。

Effects of sequential and single-step culture media systems on human oocyte fertilization and early embryo development

Objective: To compare the effects of sequential and single-step culture media systems on the development of human early embryo in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles, and to provide a reference for the selection and evaluation of the human embryo culture system of assisted reproductive technology (ART). Methods: A total of 155 patients received IVF/ICSI treatment were selected and the ova from the same patient were divided into two groups. The ova were cultured in Vitrolife sequential media system G-IVF/G1/G2 culture solution(sequential culture group) and Irvine single-step media system CSCC culture solution(single-step culture group)for IVF and embryo culture.The fertilization and early embryo development in the different culture systems in two groups were observed. Results: Compared with single-step culture group, the fertilization rate, 2PN fertilization rate and multi-nuclear fertilization rate of the patients in sequential culture group had no significant differences (P>0.05). In the IVF patients, there were no significant differences in the cleavage rates, quality embryo rates, high quality embryo rates and blastocyst formation rates between sequential culture group and single-step culture group (P>0.05). In the ICSI patients, there were also no significant differences in the cleavage rates, quality embryo rates and blastocyst formation rates between sequential culture group and single-step culture group (P>0.05). However, the high quality embryo rate of the patients in sequential culture group was significantly higher than that in single-step culture group (P=0.015). Both in the IVF and ICSI patients, the percents of densification embryos in single-step culture group were significantly higher than those in sequential culture group (P=0.001). Moreover, the embryos cultured in sequental culture group were smooth and homogeneous, but the embryos cultured in single-step culture group were rough and granular. Conclusion: There are no significant differences in fertilization and early embryo development between the two culture media systems.