体外受精-胚胎移植中移植胚胎透明带厚度变量与治疗结果的相关性研究

目的 :观察移植胚胎透明带厚度变量 ( ZPTV)对体外受精 -胚胎移植 ( IVF-ET)治疗结果的影响。方法 :在 2 3 2对夫妇进行 2 51个 IVF-ET治疗周期 ,电脑记录移植胚胎图象 ,应用胚胎测量软件进行透明带厚度的测量 ,计算 ZPTV。结果 :2 51个周期共移植 747个新鲜胚胎 ,获临床妊娠 1 0 9例 ( 43 % )。妊娠周期与非妊娠周期的平均 ZPTV值分别为 1 8.4± 6.0 ,1 6.0± 5.6,差异显著 ( P<0 .0 0 5)。并根据移植胚胎的平均 ZPTV值>2 0 %胚胎数目 0、1、≥ 2个将治疗周期分为 3组 ,其临床妊娠率分别为 2 7%、51 %、55%( P<0 .0 0 5) ,胚胎种植率分别为 1 3 %、2 5%、3 0 % ( P<0 .0 0 1 ) ,均随移植胚胎数增加而显著升高。年龄 <3 5岁组 ,移植周期的多胎妊娠率随平均 ZPTV值 >2 0 %胚胎移植数 ( 0、1、≥ 2 )的增加而升高 ( 2 9%、3 4%、62 % ) ,差异有显著性 ( P<0 .0 5) ;但年龄≥ 3 5岁组 ( 3 3 %、2 0 %、2 9% ) ,无显著差异 ( P<0 .0 5) ,移植胚胎形态等级和各年龄段妇女中移植胚胎平均ZPTV值均无显著差异 ( P>0 .0 5)。结论 :移植胚胎的平均 ZPTV值与胚胎种植率、临床妊娠率和多胎妊娠率密切相关 ,平均 ZPTV是衡量胚胎质量的又一重要指标。

Relationship between the zona pellucida thickness variati on of transferred embryos and clinical outcomes in vitro fertilization and e mbryo transfer cycles

Objective: To analyze the relationship between the zona pellucida thickness variation (ZPTV) of transferred embryos and clinical outcomes in IVF ET cycles. Method: 251 IVF cycles were included in this study. The images of all transferred embryos were captured by video recorder and the zona pellucida thickness of these embryos was measured by a computerized embryo measurement program. The ZPTV of in dividual transferred embryos was calculated according to the formula ZPTV=(Zmax Zmean)/Zmean×100] Results: A total of 747 fresh embryos transferred in 251 cycles resulted in 109 clinical pregnancies (43%). The mean ZPTV of transferred embryos in pregnancy cycles (18.4±6.0)was significantly higher than that in unpregnancy cycles (16.0±6.5)( P<0.005 ). According to the number (0,1,≥2) of transferred embryos with a mean ZPTV value more than 20%, all IVF cycles were divided into three groups. Pregnancy rate (PR) and implantation rate (IR) in group 1(51%,25%) and in group ≥2(55%,30%) were higher than those in group 0(27%,13%). There were significant differences ( P<0.005,P<0.001 )among three groups. When 0,1 or ≥2 embryos with mean ZPTV values >20% were transferred, the multiple pregnancy rates in women age <35 were 29%, 34% and 62% respectively ( P<0.05 ) but the rates in women age ≥35 were 33%, 20%, 29%( P>0.05 ) respectively. No significantly correlation was found between the mean ZPTV of transferred embryos and embryo morphology (grade)( P< 0.05 ), neither did between the mean ZPTV of transferred embryos and female age ( P> 0.05 ) Conclusion: The zona pellucida thickness variation of transferred embryos correlates well with clinical outcomes and is one reliable assessment parameter for embryo quality.