原核期形态特征与胚胎体外发育能力和体内着床潜能的关系

目的探讨原核期评分系统与受精后第3天胚胎形态、受精后第6天囊胚形成和着床率之间的关系,以评估其在体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)中的应用价值。方法于常规IVF或卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)受精后16～20 h观察受精情况,将正常受精卵母细胞参照Scott提出的Z评分系统分为Z1～Z4四种类型,比较不同原核类型之间的卵裂率,胚胎第3天(D3)优质胚胎率和第6天(D6)囊胚形成率。并通过分析着床结局明确的移植胚胎,比较各种类型受精卵之间的着床率。结果 Z4组受精卵的卵裂率(92.9%)、D3优质胚胎率(14.25%)、D6囊胚形成率(10.48%)均明显低于其他各组(P<0.01)。Z4组的着床率(5.88%)很低,但各组的着床率之间差异无显著性(P>0.05)。Z1、Z2、Z3三组间的卵裂率、D3优质胚胎率、D6囊胚形成率和着床率之间差异均无统计学意义(P>0.05)。结论异常的原核形态(Z4型)可预测胚胎的体内外发育潜能,但核仁的形态特征并不一定能预测胚胎的活力,Z1、Z2和Z3胚胎可能具有相同的发育潜能。

Correlation of pronucleus morphology with in vitro development and in vivo implantation potential

Objective To study the correlation of pronucleus scoring system with embryo morphology 3 days after fertilization,blastulation and implantation rate 6 days after fertilization in order to assess its application in in vitro fertilization-embryo transfer(IVF-ET).Methods Fertilization was observed 16-20 h after insemination during conventional IVF or intracytoplasmic sperm injection(ICSI).Normal fertilized zygotes were divided into groups Z1,Z2,Z3 and Z4 according to the Z scoring system developed by Scott.Cle...