体外低氧培养系统下的高质量早期人胚形态学特征

目的：探讨低氧（7.5%O2）和高氧（20%O2）培养体系对人早期胚胎（D1-D3）体外发育及胚胎移植临床结局的影响．方法选取2012年2月至2013年8月在云南省第二人民医院生殖医学中心接受常规IVF-ET治疗，行D3新鲜胚胎移植的周期资料，共280个周期，比较7.5%O2低氧组（120个周期）和20%O2高氧组（160个周期）早期胚胎体外发育的结果和胚胎移植的临床结局．结果低氧组D3优级胚胎形态外观上明显有别于次优级胚胎（即传统优级胚胎），呈卵裂球紧贴，裂球边界渐模糊的形态学特征，且优级胚胎率显著高于高氧组（66.22%与47.54%），但2组受精率、卵裂率和可用胚胎率比较差异无统计学意义．低氧组胚胎的着床率显著高于高氧组（42.94%与31.01%），生化妊娠率（62.22%与47.06%）和临床妊娠率（53.33%与39.22%）也均比高氧组高．结论体外低氧培养系统能产生质量更高的人早期胚胎，对提高IVF临床结局有益．

Morphologic Characteristic of Human Embryo Cultured in Vitro under Low Oxygen Tension

Objective To investigate the effect of low oxygen tension （7.5% O2） on human embryo development in vitro and outcome of women undergoing IVF-ET. Methods The data of 280 routine IVF cycles with fresh embryo transfer on day3 conducted in the 2nd People＆#39;s Hospital of Yunnan Province from February 2012 to August 2013 were retrospectively analyzed. Two groups, 7.5%O2 low oxygen tension （n=120） and 20%O2 high oxygen tension （n=160）,were setup for early embryo （D1-D3） development in vitro. Results Good quality embryo on day 3 in low oxygen tension group showed morphologically appearance of blastomere mutually clinging to each other,a characteristic of slight compaction. Higher rate of good quality embryo （66.22%V. 47.54%） and of clinical pregnancy （53.33%v. 39.22%） were found in the low oxygen tension group. There were no significantly differences in rates of fertilization,cleavage and embryo utilization respectively between the two groups （P all〉0. 05） . Conclusion High quality early stage human embryos can be developed in vitro in low oxygen tension, and may improve clinic outcome of IVF.