摘要
目的观察应用时差成像技术(TLI)筛选后的移植胚胎2细胞期卵裂球多核情况对新鲜周期Day 3(D3)单卵裂期胚胎移植后临床结局的影响,探究2细胞多核来源卵裂胚的临床应用价值。方法回顾性分析2022年1月至2023年12月于南京大学医学院附属鼓楼医院生殖医学中心行新鲜周期D3单卵裂胚移植的782例患者的临床资料,通过TLI动态观察并分析移植胚胎2细胞期卵裂球核状态、D3胚胎静态形态学参数以及发育动力学参数。根据2细胞期卵裂球多核情况分为2细胞无多核组(A组,n=642)、2细胞单卵裂球多核组(B组,n=91)、2细胞双卵裂球多核组(C组,n=49),分析2细胞期卵裂球多核对D3单胚胎移植临床结局及新生儿结局的影响。结果一般资料:3组间平均年龄、内膜厚度、不孕年限、受精方式占比、体质量指数(BMI)、基础卵泡刺激素(bFSH)、基础黄体生成素(bLH)、基础雌二醇(bE_(2))、获卵数均无统计学差异(P>0.05)。移植胚胎发育动力学参数:3组间均无统计学差异(P>0.05)。妊娠结局:3组间生化妊娠率、临床妊娠率、流产率、异位妊娠率、活产率、多胎率差异均无统计学意义(P>0.05)。新生儿结局:3组间孕周、早产率、新生儿体重、新生儿身高、性别比(男/女)、胎儿畸形率差异均无统计学意义(P>0.05)。结论基于TLI技术,在严格控制卵裂模式和形态动力学参数的前提下,移植胚胎2细胞期卵裂球多核对新鲜周期D3单卵裂胚移植的临床结局无明显不良影响。
Objectives:To explore the clinical application value of embryos derived from multinucleated 2-cell blastomeres by observing the impact of blastomere multinucleation at 2-cell stage screened by time-lapse imaging(TLI)on the clinical outcomes of single fresh Day 3(D3)cleavage-stage embryo transfer.Methods:A retrospective analysis was conducted on the clinical data of 782 patients who underwent single fresh D3 cleavage-stage embryo transfer at the Reproductive Medicine Center of Nanjing University Medical School Affiliated Drum Tower Hospital between January 2022 and December 2023.TLI was used to dynamically observe and analyze the nuclear status of blastomeres at the 2-cell stage of the transferred embryos,as well as the static morphological parameters and developmental kinetics of the D3 embryos.Based on multinucleation at the 2-cell stage,patients were divided into three groups:the non-multinucleation group(group A,n=642),the single blastomere multinucleation group(group B,n=91),and the double blastomere multinucleation group(group C,n=49).The influence of blastomere multinucleation at 2-cell stage on clinical outcomes and neonatal outcomes after D3 single embryo transfer was analyzed.Results:With regard to general information,there were no statistically significant differences in average age,endometrial thickness,duration of infertility,proportion of fertilization methods,body mass index(BMI),basal levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E_(2)),and number of retrieved oocytes among the three groups(P>0.05).There were no statistically significant differences in developmental kinetic parameters of transplanted embryos among the three groups(P>0.05).For pregnancy outcomes,no statistically significant differences were observed in biochemical pregnancy rates,clinical pregnancy rates,miscarriage rates,ectopic pregnancy rates,live birth rates,multiple pregnancy rates among the three groups(P>0.05).For neonatal outcomes,no statistically significant differences were found in gestational age,preterm birth rates,neonatal birth weight,neonatal height,sex ratio(male/female)and fetal malformation rates among the three groups(P>0.05).Conclusions:Based on TLI technology,and under the premise of strict control over cleavage patterns and morphokinetic parameters,multinucleation in blastomeres at the 2-cell stage of transferred embryos does not appear to have a significant adverse effect on clinical outcomes of single fresh D3 cleavage-stage embryo transfer.
作者
陈磊
蒋益群
蒋如煜
王珊珊
CHEN Lei;JIANG Yi-qun;JIANG Ru-yu;WANG Shan-shan(Center for Reproductive Medicine and Obstetrics and Gynecology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008)
出处
《生殖医学杂志》
2025年第12期1600-1605,共6页
Journal of Reproductive Medicine
基金
南京鼓楼医院临床研究专项资金培育项目(2021-LCYJ-PY-08)。
关键词
卵裂球多核
单胚胎移植
时差成像技术
临床结局
Blastomere multinucleation
Single embryo transfer
Time-lapse imaging
Clinical outcome
