合子联合卵裂期胚胎评级与胚胎着床关系的研究

Correlation between the Pronuclear Nucleoli and the Developmental Competence with Implantation Potential for Human Embryos

目的:探讨原核期合子评级体系及核仁数目差异和早期胚胎选择方法与胚胎着床之间的关系。方法:对90个行体外受精-胚胎移植及单精子卵泡浆注射(IVF/ICSI)治疗周期,共689枚授精后第1天观察为正常受精的卵子,在受精后16～18小时根据合子的核仁前体数目和分布情况,将其分为Z1、Z2、Z3和Z4共4个等级,并对胚胎的形态学、着床率和妊娠率进行评估,同时将原核核仁数目差值进行分类,比较其与胚胎发育的相关性。结果:Z评级高的合子在卵裂率、优质胚胎形成率、妊娠率及着床率方面显著高于Z评级低的合子,组间比较差异有高度统计学意义(P<0.01);分析正常受精卵核仁差异发现,核仁数间的差异不影响胚胎的后期卵裂以及优质胚胎的形成(P>0.05)。结论:原核期合子评级作为简单、快速和无创伤的参数可以较客观地反映合子质量,对后期胚胎选择具有重要意义,同时核仁数目的差异并不影响胚胎的早期发育,但需进一步研究。

Objective： To investigate the relations of the zygocyte grading in prokaryotic stage, the discrepancies of nucleoli amount, the method of selecting early-period embryos and the embryos implantation. Methods：The pronuciei grading system was to grade 689 normal zygotes from 90 treatment cycles of IVF or intracytoplasrnic sperm injection （ICSI）. At 16 - 18 hours after insemination, these zygotes are classified into four grades： Z1, 79, 23, and Z4 according to the distribution and amount of the pronuclear nucleoli. By estimating the morphology, implantation rate and pregnancy rate of the embryos, combined with classifying differences of the amount of the pronuclear nucleoli, to compare the relativity of the embryo development. Results： The higher grade zygotes group had obviously better cleavage rate, high-quality embryos forming rate, pregnancy rate, and implantation rate, and had notable differences than lower grade groups（ P〈 0.01 ） ; simultaneously, the discrepancies among normal zygotes nucleoli did not affect the anaphase cleavage of embryos and the formation of high-quality embryos （ P〉 0.05）. Conclusions： The zygecyte grading system during prokaryotic stage is greatly significant to the selections of anaphase embryos, simultaneously, the greater difference in the amount of nucleoli, the lower tendency of the cleavage rate and fine embryos forming rate would be,however,for there is no statistical significance,further study would be needed.