摘要
目的比较未见原核(0PN)与正常原核(2PN)来源优质囊胚的妊娠结局,探讨0PN胚胎的利用价值。方法收集2013年1月至2014年12月在本中心行助孕治疗、鲜胚移植失败或取消移植后行冻融优质囊胚移植的784例患者为研究对象,以移植0PN来源冻融优质囊胚的患者为0PN组,移植2PN来源冻融优质囊胚的患者为2PN组,分析0PN、2PN卵裂胚的优质囊胚形成率,并比较两组患者的胚胎种植率、临床妊娠率和流产率等。结果 0PN卵裂胚的总优质囊胚形成率显著低于2PN卵裂胚(37.17%vs.44.49%),但第3天卵裂球8细胞以上胚胎优质囊胚形成率0PN胚胎显著高于2PN胚胎(67.45%vs.57.16%)(P均<0.01)。囊胚移植后0PN组的种植率(71.15%vs.53.74%)、临床妊娠率(80.00%vs.64.32%)、抱婴率(68.00%vs.55.71%)显著高于2PN组(P均<0.05);两组出生婴儿体重、身长、Apgar评分、畸形率等比较无显著性差异(P>0.05)。结论 0PN来源优质囊胚的利用价值值得关注。0PN胚胎可能只是在设定的观察时间内未观察到原核,而并不一定是异常受精。对于无可利用优质胚胎的患者,临床上可以将0PN胚胎继续培养至囊胚,然后进行移植,以提高患者的胚胎利用率和临床妊娠率。但因为0PN胚胎存在染色体异常的可能性仍较大,建议能结合遗传学筛查技术,以获得更确切的信息,指导临床应用。
Objective： To compare the pregnancy outcome of high-quality blastocyst from two pronucleus（2PN）or zero pronucleus（0PN）embryos,and further analyze the value of zero pronucleus embryos.Methods： A total of 784 patients with frozen-thawed transfer with high-quality blastocyst after fresh embryo transfer failure or cancel of transfer cycle in our center from Jan.2013 to Dec.2014 were enrolled for the study.The patients were divided into two groups according to the high-quality blastocyst derived from 0PN or 2PN embryos：the 0PN-derived group and the 2PN-derived group.The high-quality blastocyst rate,implantation rate,clinical pregnancy rate and miscarriage rate were compared between the two groups.Results：In general,the high-quality blastocyst rate from 0PN-derived embryo was significantly lower than that from 2PN-derived embryo（37.17% vs.44.49%,P 0.01）,but the rate of high-quality blastocyst with more than 8cells derived from 0PN embryo on Day 3was significantly higher than that from 2PN embryo（67.45% vs.57.16%,P〈0.01）.The implantation rate（71.15% vs.53.74%）,clinical pregnancy rate（80.00% vs.64.32%）and live birth rate（68.00% vs.55.71%）in 0PN-derived embryo group were significantly higher than those in the 2PN-derived embryo group（all P〈0.05）.The birthweight,Apgar score,and malformation rate were not significantly different between the two groups（P〈0.05）.Conclusions：It is worthy to utilize high-quality blastocyst derived from 0PN embryos.For patients without high quality embryos to use,their 0PN embryos can be cultured to blastocyst and then transplant,in order to improve the embryos utilization rate and clinical pregnancy rate.
出处
《生殖医学杂志》
CAS
2016年第8期696-700,共5页
Journal of Reproductive Medicine
基金
南京军区医药卫生科研基金课题(12Z37)
关键词
原核
细胞数
优质囊胚形成率
种植率
临床妊娠率
Pronucleus
Cell number
High-quality blastocyst rate
Implantation rate
Clinical pregnancy rate
