摘要
目的:观察早期卵裂和原核消失在体外受精-胚胎移植(IVF-ET)治疗中的应用价值。方法:①对行IVF-ET治疗的210例239个周期,于受精后18～19h观察受精情况,25～26h观察早期卵裂与原核消失情况,66～68h再进行1次胚胎观察,了解其临床妊娠率和胚胎种植率。②根据移植胚胎中有无早期卵裂或原核消失将患者分为:早期卵裂或原核消失组(139例152个周期)与无早期卵裂或原核消失组(71例87个周期),比较两组优质胚胎率、临床妊娠率和胚胎种植率。结果:①临床妊娠率为42.7%,胚胎种植率为28.9%。②发生早期卵裂的胚胎在受精后第3日的优质胚胎率高于未发生早期卵裂的胚胎(P<0.01);发生2原核消失(2PNBD)胚胎在受精后第3日的优质胚胎率又高于2原核(2PN)持续存在的胚胎(P<0.01)。③有早期卵裂或原核消失组的优质胚胎率(75.5%)、临床妊娠率(44.7%)和胚胎种植率(29.5%)分别高于无早期卵裂或原核消失组(P<0.01)。在早期卵裂或原核消失组,随移植胚胎中发生早期卵裂或原核消失的胚胎数目增加,妊娠率及多胎妊娠率有增加趋势。④受精25～26h,有0.95%的2PN合子变成≥3PN合子;1.37%的2PN合子变成1PN合子;0.83%的1PN合子变成2PN合子。结论:早期卵裂和原核消失可以作为选择移植胚胎的一个指标,可作为辅助生殖技术实验室常规观察项目,提高IVF-ET成功率。
Objective ： To examine the application value of observing early pronuclear breakdown （EPNBD） and early cleavage （EC） on the clinical treatment with in vitro fertilization -embryo transfer （IVF- ET）. Methods ： （1） 210 cases of 239 cycles receiving the IVF - ET treatment were observed between February 2006 and February 2008. The fertilization situations were confirmed at 18 - 19h post - insemination, EPNBD and EC were examined at 25 - 26h, and embryo observation was carried out at 66 - 68h to know the pregnancy rate （PR） and implantation rate （IR）. （2） Patients were categorized into two groups according to the situation of the transferred embryos： EPNBD/EC group （139 cases of 152 cycles） and non -EPNBD/EC group （71 cases of 87 cycles）. And the high quality embryo formation rate, PR and IR were compared between the two groups. Results： （1） The PR and IR were 42.7% and 28.9%, respectively. （2） The high quality embryo formation rate of the EC group in the third day after insemination was higher than the non - EC group （ P 〈 0.01 ）, and the same rate of the 2PNBD group was higher than the 2PN group （P 〈 0.01 ）. （3） The high quality embryo formation rate （75.5%） , PR （44.7%） and IR （29.5%） of the EPNBD/EC group were higher than the non - EPNBD/EC group （ P 〈 0.01 ） , respectively. And the PR and multiple - PR of the EPNBD/EC group increased as the incidence rates of EC or EPNBD in the transferred embryos added. （4） 0. 95% zygotes with 2PN turned into zygotes with three or more PN at 25 - 26h post - insemination, 1.37% zygotes with 2PN turned into zygotes with 1PN, and 0.83% zygotes with 1PN turned into zygotes with 2PN. Conclusion： EPNBD and EC can be used as effective indexes for transferred embryo selection, and an observation item of assisted reproductive technology laboratory routine examination, to promote the achievement ratio of IVF - ET.
出处
《中国计划生育学杂志》
北大核心
2008年第10期617-620,共4页
Chinese Journal of Family Planning
关键词
早期卵裂
早期原核消失
妊娠率
种植率
Early cleavage
Early pronuclear breakdown
Pregnancy rate
Implantation rate
