继续囊胚培养筛选非优质胚胎中具有发育潜能胚胎的可行性研究

目的：探讨继续囊胚培养筛选非优质胚胎中具有发育潜能胚胎的可行性。方法收集生殖中心142例IVF/ICSI治疗周期中受精后第3天（ D3）移植、冷冻保存后剩余的538枚非优质胚胎继续囊胚培养至第6天（D6），观察其囊胚形成情况，并将其按不同卵裂球数和评级分为4组（4细胞Ⅰ、Ⅱ、Ⅲ级胚胎组、5细胞Ⅰ、Ⅱ、Ⅲ级胚胎组、6～9细胞Ⅲ级胚胎组和＞9细胞Ⅰ、Ⅱ、Ⅲ级胚胎组），比较4组间囊胚形成的情况。结果非优质胚胎的囊胚形成率为65．6％，优质囊胚率为51．3％，其中4个组的囊胚形成率分别是55．6％、56．6％、70．4％和66．7％，差异有统计学意义（ P＜0．05）；优质囊胚率分别是8．9％、32．6％、61．0％和63．3％，差异有统计学意义（P＜0．05）。结论继续囊胚培养能有效筛选出非优质胚胎中具有发育潜能的胚胎，提高其利用率。

Feasibility of selecting viable embryos from poor quality embryos by blastocyst culture

Objective To investigate the feasibility of screening viable embryos from poor quality embryos by extending blastocyst culture .Methods 538 D3 poor quality embryos from 142 cases IVF/ICSI treatment were collected after embryo transfer or freezing , and observe the blastocyst formation by blastocyst cultured for up to the sixth days （ D6 ） .The embryos were divided into four groups （ 4 cells gradeⅠ/Ⅱ/Ⅲembryos, 5 cells gradeⅠ/Ⅱ/Ⅲ embryos, 6 ~9 cells grade Ⅲ embryos and exceed 9 cells gradeⅠ/Ⅱ/Ⅲembryos） according to different blastomere and grade , and then compared the blastula development .Results The blastula formation rate and the high-quality blastula rate from D3 poor quality embryos were 65.6%and 51. 3%, the blastula formation rate of the four groups were 55.6%,56.6%,70.4% and 66.7%, there were significant difference among the four groups （P〈0.05）.And the high-quality blastula rate were 8.9%, 32.6%, 61.0% and 63.3%, there were significant difference among the four groups （P 〈0.05）.Conclusions Extending blastocysts cultured can select the developmental potential embryos from those poor quality embryos remnant effectively , and make better use of the embryos .