摘要
目的 分析常规IVF后固定时间原核评估中零原核(0PN)来源胚胎的发育潜能及其染色体整倍体率。方法 回顾性分析2019年10月至2020年9月于本中心行常规IVF治疗的20对不孕不育夫妇的临床资料。共纳入183枚卵母细胞,剔除14枚0PN卵母细胞(处于未受精状态)后,根据原核评估以及细胞分裂情况分为两组:2个原核(2PN)来源胚胎为2PN胚胎组(n=116),0PN来源胚胎为0PN胚胎组(n=53),比较两组患者的胚胎发育情况;同时,为了分析0PN来源胚胎的染色体是否正常,选取0PN来源囊胚为0PN囊胚组(n=42),选取同一时期的植入前遗传学检测-单基因病(PGT-M)周期中2PN来源囊胚为2PN囊胚组(n=251),比较两组患者的染色体整倍体率。结果 0PN胚胎组Day 2(D2)卵裂球数[(5.74±1.40)个vs.(4.32±1.01)个]、D3卵裂球数[(10.15±2.29)个vs.(7.95±1.97)个]、囊胚形成率(86.8%vs. 60.3%)、可利用囊胚率(91.3%vs. 66.0%)均显著高于2PN胚胎组(P<0.05);0PN胚胎组的优质囊胚率(47.8%)略高于2PN胚胎组(31.9%),但差异无统计学意义(P>0.05)。0PN囊胚组的染色体整倍体率(76.2%)略高于2PN囊胚组(75.7%),但差异无统计学意义(P>0.05)。结论 在常规IVF中,使用固定时间原核评估方法获得的0PN来源胚胎具有较高的发育潜能,其染色体整倍体率也略高于同期PGT-M-2PN来源囊胚;提示大部分0PN来源胚胎由于固定时间原核评估而错过了原核观察,实际上可能源自于正常受精卵,因此其临床应用价值应结合PGT进行重新评估。
Objective:To analyze the developmental potential and chromosomal euploidy rate of 0PN-derived embryos from fixed-point assessment in conventional in vitro fertilization(IVF).Methods:The clinical data of 20 infertile couples who received IVF assisted pregnancy in our reproductive center from October 2019 to September 2020 were retrospectively analyzed.A total of 183 oocytes were included and 140PN oocytes(unfertilized oocytes)were removed.According to pronucleus assessment and cell division,the oocytes were assigned to two groups:2PN-derived embryos group(2PN embryo group,n=116)and 0PN-derived embryos group(0PN embryo group,n=53).The embryonic development potential was compared between the two groups.In order to analyze whether the chromosomes of 0PN-derived embryos are normal,the blastocysts from different sources were divided into two groups:0PN blastocysts group(n=42)and the 2PN-derived blastocysts from preimplantation genetic testing for monogenic disease(PGT-M)cycles at the same period were selected as 2PN blastocysts group(n=251),and chromosome euploidy rate between two groups was compared.Results:The number of Day 2 blastomeres[(5.74±1.40)vs.(4.32±1.01)],the number of Day 3 blastomeres[(10.15±2.29)vs.(7.95±1.97)],the blastocyst formation rate(86.8%vs.60.3%),and the available blastocyst rate(91.3%vs.66.0%)in the 0PN embryo group were significantly higher than those in the 2PN embryo group(P<0.05).The rate of high-quality blastocysts in 0PN embryo group(47.8%)was slightly higher than that in 2PN embryo group(31.9%),but the difference was not significant(P>0.05).The chromosome euploidy rate of 0PN blastocyst group(76.2%)was slightly higher than that of 2PN blastocyst group(75.7%),but the difference was not significant(P>0.05).Conclusions:In conventional IVF,the 0PN-derived embryos from fixed-point assessment possess have higher developmental potential,as well as a higher chromosomal euploidy rate.Therefore,the clinical value of 0PN-derived embryos needs to be evaluated in combination with preimplantation g
作者
赵海静
袁萍
赵珺
冀晓慧
张清学
王文军
ZHAO Hai-jing;YUAN Ping;ZHAO Jun;JI Xiao-hui;ZHANG Qing-xue;WANG Wen-jun(Reproductive Center,Sun Yat-Sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120)
出处
《生殖医学杂志》
CAS
2022年第11期1488-1493,共6页
Journal of Reproductive Medicine
基金
广东省自然科学基金面上项目(2019A1515012005)。
关键词
体外受精
零原核胚胎
发育速度
染色体整倍体
In vitro fertilization
0PN-derived embryo
Developmental potential
Chromosomal euploidy
