摘要
目的探讨胚胎发育速度及形态评级并参考受精卵原核评级(联合评级),对行体外受精胚胎移植及卵母细胞质内单精子注射后移植胚胎筛选的意义。方法回顾性分析我院2003年5—12月,采用联合评级筛选进行胚胎移植的434个周期,共2714个正常受精卵的资料。根据受精卵原核发育是否同步,分为原核发育同步组和原核发育不同步组,观察不同原核等级受精卵的发育潜力;首先根据胚胎发育速度及形态评级,再根据受精卵原核等级的联合评级选择移植胚胎。根据移植胚胎中是否含有原核发育同步的胚胎,比较原核发育同步组与原核发育不同步组受精卵进行胚胎移植后的临床妊娠率和着床率。结果2714个正常受精卵中,原核发育同步组受精卵1774个,其中优质胚胎743个,优质胚胎率为41.88%;原核发育不同步组受精卵940个,其中优质胚胎319个,优质胚胎率为33.94%,两组比较,差异有统计学意义(P<0.01)。原核发育同步组中胚胎移植周期395个,临床妊娠率为47.85%(189/395),着床率为27.49%(273/993);原核发育不同步组中胚胎移植周期39个,临床妊娠率为43.59%(17/39),着床率为25.00%(21/84)。两组比较,差异无统计学意义(P>0.05)。结论采用联合评级,受精卵原核发育同步组与发育不同步组胚胎的临床妊娠率及着床率无差异;参考原核评级不能预测更高的妊娠率和着床率,但能预测胚胎发育的潜力。
Objective To evaluate the vaiue of using a combined grading for embryo growth rate and morphology and zygote pronuclear morphology, and to select embryos for transfer in clinical in-vitro fertilization （ IVF）/ intra-cytoplasmic sperm injection （ICSI）. Methods In this retrospective study, a total of 2714 normal zygotes （2 pronuclei） from 434 treatment cycles with IVF/ICSI was analyzed between May 2003 and December 2003. These zygotes were divided into two groups （synchronous group and nonsynchronous group） according to the developmental synchrony of pronuclei. The developmental potential of zygotes from these two groups was observed. Embryos for transfer were selected initially by embryo growth rate and morphology, secondarily by zygote grade. The clinical pregnancy rates and implantation rates were compared according to whether the embryos from synchronous group were transferred. Results There were 2714 normal zygotes, the good-quality embryos（≥6 cells, grade Ⅰ-Ⅱ ） rate of the synchronous group （41.88% ,743/1774） was significantly higher （ P〈0.001 ） than the nonsynchronous group （ 33.94%, 319/940）. Totally 395 cycles transferred at least one embryo from synchronous group, the clinical pregnancy rate was 47. 85% （189/395） and implantation rate was 27.49% （273/993）. There was no significant difference from 39 cycles which did not transfer embryos from nonsynchronous group. The clinical pregnancy rate was 43. 59% （17/39） and implantation rate was 25.00% （21/84）. Conclusion The data indicate that there are no significant differences in pregnancy rates and implantation rates between different zygote grade when selecting embryos for transfer by combined grading.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2006年第5期319-321,共3页
Chinese Journal of Obstetrics and Gynecology
关键词
联合评级
受精卵原核评级
胚胎选择
优质胚胎
Combined grading
Zygote grading
Embryo selection
Good-quality embryo
