人胚胎透明带厚度及其变量与体外受精-胚胎移植妊娠结局的关系

目的　探讨透明带厚度 (ZPT)及透明带厚度变量 (ZPTV)与体外受精 胚胎移植 (IVF ET)妊娠结局的关系。　方法　选择 2 0 0 2年 4～ 8月间连续进行的培养 3d新鲜的用于移植、形态摄像清楚的 81个周期 2 4 6个胚胎进行分析 ,用激光系统附带软件测量移植胚胎ZPT ,计算ZPTV。　结果　 (1)ZPT、ZPTV随患者年龄的增加而减小 ,尤其≥ 35岁组ZPTV(16 .2 3± 4 .78) %显著小于 <30～ 34岁组 (2 0 .14± 5 .91) % (P <0 .0 0 1) ;(2 )妊娠组 (87个胚胎 )ZPT(16 .71± 2 .10 ) μm小于未妊娠组 (15 9个胚胎 ) (17.0 6± 1.75 ) μm ,但无显著差异 ;妊娠组ZPTV(2 1.73± 5 .6 1) %显著大于未妊娠组 (18.6 1± 4 .90 ) %(P <0 .0 0 5 )。移植胚胎平均ZPTV值≥ 2 0 %组的妊娠率 (5 0 .0 % )高于 <2 0 %组 (17.1% ) ,P <0 .0 5 ;(3)优质胚胎组 (2 4 6个胚胎 )ZPT(16 .84± 1.99) μm与劣质胚胎组 (12 7个胚胎 )ZPT(17.11± 2 .0 4 ) μm相比无显著差异 ;但优质胚胎组ZPTV(19.71± 5 .39) %大于劣质胚胎组 (16 .6 0± 5 .4 2 ) % ,P <0 .0 0 1。　结论　ZPTV是评价胚胎质量的一个有效指标 ,优质胚胎的ZPTV高于劣质胚胎 ,年龄≥ 35岁者ZPTV显著减小 ;移植胚胎平均ZPTV值≥ 2 0 %者妊娠率明显提高。在临床挑选移植胚胎时应?

The relationship of zona pellucida thickness / zona pellucida thickness variation of human embryos and clinical pregnancy outcome following in vitro fertilization treatment

Objective: To investigate the relationship of zona pellucida thickness (ZPT) / zona pellucida thickness variation (ZPTV) of human embryos and clinical pregnancy outcome following in vitro fertilization treatment. Method: Two hundred and forty-six embryos, with clear image record from 81 IVF-ET cycles during a five-month period from April 2002 to August 2002, were selected for transfer on day 3. The laser system measurement software was used to measure the ZTP of the embryo and the ZPTVs were calculated. Results: (1) Both ZPT and ZPTV declined with women’s age. The ZPTV value of embryos from the patients between 30 and 34 years old (20.14±5.91)% was significantly higher than that of embryos from the patients aged 35 years or over (16.23±4.78)%(P<0.001). (2) The ZPTs for the conceptual cycles and nonconceptual cycles were(16.71±2.10) μm and (17.06±1.75) μm, respectively, and no statistic significance was found (P>0.05); The ZPTVs for the conceptual cycles and nonconceptual cycles were (21.73±5.61) and (18.61±4.90)%, respectively, and the difference had a statistic significance (P< 0.005).The clinical pregnancy rate of the embryos with mean ZPTV value more than 20% (50.0%) was significantly higher than that of those with mean ZPTV value less than 20% (17.1%), P<0.05. (3) The ZPTs of 246 higher grade embryos (for transfer) and 127 lower grade embryos (discarded) were (16.84±1.99) and (17.11±2.04) μm, respectively, and there was no statistic significance between the two groups, P>0.05; However, the ZPTVs of these two groups were (19.71±5.39) and (16.60±5.42)%, respectively, which showed a significant difference (P<0.001).Conclusions: ZPTV, rather than ZPT, is a reliable parameter to evaluate the embryo quality. Embryos with better scores had higher ZPTV values, and the embryos from patients aged 35yrs or over had lower ZPTV values. ZPTV exhibits a strong correlation with the clinical pregnancy outcome. The patients transferred with the embryos with ZPTV more than 20% had a significantly improved pregnancy rate. These suggest that we should choose those embryos with ZPTV more than 20% for embryo transfer, and we may increase the ZPTV artificially by zona local thinning in order to enhance their implantation potential.