胚胎早裂联合胚胎发育速度及形态评分在胚胎选择中的应用

Application of early cleavage embryo in combination with embryo growth rate and morphology scoring in embryo selection

目的探讨胚胎早裂联合胚胎发育速度及形态评分对于体外授精/卵母细胞单精子显微注射(IVF/ICSI)周期中胚胎选择的意义。方法IVF/ICSI 610周期,随机分为A、B两组。A组(269周期)单以授精后72 h(D3)胚胎发育速度及形态评分选择胚胎;B组(341周期)在此基础上联合胚胎早裂情况进行胚胎选择。比较两组的临床妊娠率和单胚着床率;比较B组移植胚胎中有早裂胚胎和无早裂胚胎者的妊娠结局。结果B组临床妊娠率和单胚着床率均高于A组(P<0.05);B组移植胚胎中有早裂胚胎者的临床妊娠率和单胚着床率均高于无早裂胚胎者(P<0.01)。结论与单纯的胚胎发育速度及形态评分比较,胚胎早裂联合胚胎发育速度及形态评分进行胚胎评价可显著改善IVF/ICSI的临床结局。

Objective To evaluate the role of early cleavage embryo in combination with embryo growth rate and morphology scoring in embryo selection in in vitro fertilization/intracytoplasmic sperm injection （IVF/ICSI） cycles. Methods Six hundred and ten IVF/ICSI cycles were randomly assigned to group A（269 cycles） and group B（341 cycles）. In group A, transferred embryos were chosen according to embryo growth rate and morphology scoring by 72 h（D3） after fertilization, while early cleavage embryo was added to the selecting system in group B. The pregnancy rate and implantation rate were compared between two groups, and the clinic outcomes were compared between transfers with early cleavage embryos and without early cleavage embryos in group B. Results The pregnancy rate and implantation rate in group B were significantly higher than those in group A （P 〈 0.05）. Transfers with early cleavage embryos also achieved much higher pregnancy rate and implantation rate in group B （ P 〈 0.01）. Conclusion Compared with embryo growth rate and morphology scoring, early cleavage embryo in combination with embryo growth rate and morphology scoring can improve the clinical outcomes in IVF/ICSI cycles.