摘要
目的探讨利用激光破膜软件测量计算受精卵原核面积差及合子胞质平均直径,寻找一种客观评价两原核(2PN)受精卵的方法,从而提高胚胎选择准确率,有助于实行单囊胚移植。方法回顾性分析接受助孕治疗患者的194个改良长方案新鲜第5天(D5)单囊胚移植周期,应用激光破膜软件测量所移植胚胎的合子期2PN直径、合子胞质平均直径,计算合子期2PN面积差。通过形态学参数的变化,评估胚胎发育潜能。结果194个新鲜D5单囊胚移植周期,活产组116个周期,未活产组78个周期。两组女方年龄、不孕年限、体质量指数、基础卵泡刺激素(bFSH)、基础雌二醇(bE2)、窦卵泡计数(AFC)、基础促黄体生成素(bLH)、基础抗缪勒氏管激素(bAMH)、促性腺激素(Gn)启动总剂量、Gn启动总天数、人绒毛膜促性腺激素(HCG)日内膜厚度、HCG日血雌二醇(E2)、HCG日血促黄体生成素(LH)、HCG日血孕酮(P)、穿卵数、获卵数、MⅡ卵数、2PN面积差比较差异均无统计学意义(P>0.05);活产组移植优胚数(1.0±0.2)个多于未活产组的(0.9±0.3)个,合子胞质平均直径(111.3±7.2)μm长于未活产组的(109.1±5.8)μm,差异具有统计学意义(P<0.05);根据合子胞质平均直径不同分为A组(<115.0μm,158个移植周期)和B组(≥115.0μm,36个移植周期)。B组女方年龄(32.1±4.3)岁、Gn启动总剂量(2510.4±859.8)IU、活产率77.8%均高于A组的(30.4±4.0)岁、(2162.7±1321.4)IU、55.7%,Gn启动总天数(12.3±1.9)d长于A组的(11.0±2.0)d,差异具有统计学意义(P<0.05)。结论合子胞质平均直径可纳入胚胎评估标准的辅助指标中,以期增加患者活产的机会。
Objective To explore a method for objective evaluation of two pronuclear(2PN)zygote by measuring and calculating the prokaryotic area of fertilized eggs and mean diameter of zygote cytoplasm by using laser membrane breaking software,so as to improve the accuracy of embryo selection and facilitate single embryo transfer.Methods A retrospective analysis was performed on 194 modified long protocol fresh day 5(D5)single blastocyst transfer cycles in patients undergoing assisted conception treatment,and laser membrane breaking software was applied to measure the 2PN diameterat at zygotic stage,mean diameter of zygote cytoplasm,and calculate the 2PN area difference at zygotic stage of the transferred embryos.The developmental potential of the embryos was assessed by the changes in morphological parameters.Results 194 fresh D5 single blastocyst transfer cycles,including 116 cycles in the live birth group and 78 cycles in the non-live birth group.There was no statistically significant difference between the two groups in terms of female partner's age,years of infertility,body mass index,basal follicle stimulating hormone(bFSH),basal estradiol(bE2),sinus follicle count(AFC),basal luteinizing hormone(bLH),basal anti-Müllerian hormone(bAMH),total gonadotropin(Gn)initiation dose,total days of Gn initiation,endometrial thickness on the day of human chorionic gonadotropin(HCG)administration,estradiol(E2)on day of HCG administration,luteinizing hormone(LH)on day of HCG administration,progesterone(P)on day of HCG administration,number of penetrated oocytes,number of retrieved oocytes,number of MⅡoocytes,and 2PN area difference(P>0.05).The number of transferred high-quality embryo was(1.0±0.2)embryos in the live birth group,which was more than(0.9±0.3)embryos in the non-live birth group;the mean diameter of zygote cytoplasm was(111.3±7.2)μm in the live birth group,which was longer than(109.1±5.8)μm in the non-the live birth group;the differences were statistically significant(P<0.05).According to the mean diameter of zyg
作者
邓星
韩艳
彭伟
段超群
李清
刘珍
解兴兴
DENG Xing;HAN Yan;PENG Wei(Department of Reproduction,Yichun Maternal and Child Health Hospital,Yichun 336000,China)
出处
《中国实用医药》
2023年第2期15-19,共5页
China Practical Medicine
基金
江西省卫生健康委科技计划(项目编号:202140856)
江西省宜春市科技局社会发展计划项目(项目编号:JXYC2020KSA051)。
关键词
合子
原核直径
胞质平均直径
激光破膜软件
单囊胚移植
活产
Zygote
Prokaryote diameter
Mean diameter of cytoplasm
Laser membrane breaking software
Single blastocyst transplantation
Live birth
