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人原核期胚胎形态与胚胎移植后着床的关系
引用本文:李劲,陈士岭,孙玲,邢福祺.人原核期胚胎形态与胚胎移植后着床的关系[J].南方医科大学学报,2007,27(7):1057-1060,1064.
作者姓名:李劲  陈士岭  孙玲  邢福祺
作者单位:1. 解放军第一八七医院妇产科,海南,海口,571159
2. 南方医科大学,南方医院生殖医学中心,广东,广州,510515
摘    要:目的 探讨多个原核期形态学指标与取卵后第3天胚胎着床之间的关系,验证并筛选能正确反映胚胎移植后种植潜能的原核期形态指标.方法 选取年龄均≤35岁,HCG日子宫内膜厚度均≥8 mm,且取卵后第3天进行胚胎移植后100%植入的共30个移植周期患者(植入组),同时随机选取满足上述条件的100%未植入32个移植周期患者(未植入组).根据原核期形态包括两原核是否相邻、大小、居于胞浆中的位置,核仁前体(NPB)的排列方式、大小、数目,极体是否完整,胞浆晕的有无,胞质颜色及颗粒是否正常,胞质内空泡的有无进行数据统计,比较原核期形态与胚胎种植成功与否之间的关系.结果 植入组中两原核相邻、居中、大小一致的出现率明显高于未植入组(P<0.05),其发育而来的取卵后第3天胚胎种植率明显增高.植入组中以NPB均线性排列、数目3~7个、中等大小出现率明显高于未植入组(P<0.05),其发育而来的取卵后第3天胚胎种植率明显增高.胞浆形态中胞浆颗粒增粗明显降低胚胎种植率(P<0.05),其它形态如极体、胞浆颜色、胞浆晕及胞浆内空泡均不影响胚胎种植率.结论 原核期胚胎形态可以反映受精卵的质量,但与取卵后第3天胚胎质量不完全一致,在IVF临床工作中是选择移植胚胎的一项辅助指标,能预测胚胎发育潜能.

关 键 词:人早期胚胎  辅助生殖技术  胚胎形态  胚胎评分  体外授精-胚胎移植  胚胎质量
文章编号:1673-4254(2007)07-1057-04
修稿时间:2006-01-15

Relation of human zygote morphology and implantation of the transferred embryo
LI Jin,CHEN Shi-ling,SUN Ling,XING Fu-qi.Relation of human zygote morphology and implantation of the transferred embryo[J].Journal of Southern Medical University,2007,27(7):1057-1060,1064.
Authors:LI Jin  CHEN Shi-ling  SUN Ling  XING Fu-qi
Institution:No.187 Hospital of People's Lileration Army, Haikou 571159, and Southern Medical University, Guangzhou, China. wljin912@163.com
Abstract:Objective To investigate the relationship between human embryo implantation rates and the zygote morphology and establish zygote morphologic indices that indicate the embryo implantation potential after in vitro fertilization and embryo transfer(IVF-ET).Methods Sixty-two patients with IVF-ET were enrolled in this study,who were below 35 years of age with endometrium thickness no greater than 8 mm on the day of HCG injection.Embryo transfer was performed on day 3 after oocyte retrieval,and 30 patients with successful implantation of all the embryos transferred(implantation rate of 100%) were allocated into the implantation group,and the other 32 patients with implantation failure(implantation rate of 0) served as the control group.The zygote morphologic characteristics were analyzed for the pronuclei,nucleolar precursor bodies(NPB),polar body,cytoplasmic halo,color and granulation of the cytoplasm,and the results were compared between the two groups.Results The implantation rate was significantly higher for embryos with the two pronuclei in close vicinity,central position of the pronuclei in the cytoplasm and comparable size of the two pronuclei.Embryos developed from zygotes with linear arrangement of 3 to 7 NPB in moderate sizes tented to have a higher implantation rate(P<0.05).The implantation rate could be obviously lowered when the cytoplasm contained excessive cytoplasmic granularity(P<0.05).The other morphologic characteristics of the embryos such as the polar bodies,color of the cytoplasm,cytoplasm halo,or vacuoles in the cytoplasm did not significantly impact on the implantation rate.Conclusion The morphology of the two pronuclei reflects the quality of the zygote and may help predict the developmental potential of the embryo chosen for transfer on day 3 in IVF.
Keywords:human early embryo  assisted reproduction technology  embryo morphology  embryo score  in vitro fertilization-embryo transfer  embryo quality
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