囊胚培养及囊胚移植

Culture and transfer of blastocysts

背景:利用囊胚培养技术,待胚胎形成囊胚后再植入子宫腔,缩短了胚胎移植入子宫腔发育与着床之间的间隔,且子宫收缩逐渐减少,并减少胚胎排出体外的机会,因此,囊胚移植更符合自然的生理现象。目的:追踪随访囊胚移植的临床妊娠情况。方法:采用促性腺激素释放激素激动剂及促性腺激素超促排卵。将卵泡液中捡出的卵冠丘复合物洗涤后,置于含人血清白蛋白的受精液中。授精后16～18h转移入卵裂培养液中,观察受精情况,记录原核情况并对其进行评分。第3天时观察胚胎的发育情况,记录胚胎的卵裂球数及分级。结果与结论:271例患者中,33例未培养出囊胚的患者,只有1例妊娠,余238例患者,囊胚移植后临床妊娠率49.16%,各年龄组的临床妊娠率无差异。移植囊胚其中一个为优质囊胚的患者122例,临床妊娠率56.56%;移植囊胚均未达优质的患者116例,临床妊娠率41.38%。实验结果表明:女方年龄对囊胚移植的临床妊娠率无影响;未形成囊胚的患者可取消移植,形成囊胚的患者不论是否优质囊胚,均应移植。

BACKGROUND： The blastocysts were transferred into the uterine cavity following blastocyst culture. It may shorten the period of embryo development and implantation. On the other hand, uterine contractility decreases gradually. Thus, it would decrease the opportunity of the embryo implantation in vitro. The blastocyst transfer is fit for the physiological function. OBJECTIVE： To observe the pregnancy rate following blastocyst transfer. METHODS： Patients underwent superovulation with gonadotropin releasing hormone agonist and gonadotropin. Oocyte-cumulus-corano complex were isolated from follicular fluid and immediately placed in human insemination media supplemented with human serum albumin. Fertilization was assessed and scored at 16-18 hours after insemination and transferred to cleavage media. Development of embryo and number f blastomere at 3 days were assessed and graded. RESULTS AND CONCLUSION： Only one patient was pregnant after embryo transfer among those 33 patients who had no blastocyst was transferred. The clinical pregnancy rate of 238 patients after blastocyst transfer was 49.16%. It was no statistically different of the success rate among the different maternal age. 122 patients were transferred at least one good-quality blastocyst, the clinical pregnancy rate was 56.56%. 116 patients were transferred poor-quality blastocyst, the clinical pregnancy rate was 41.38%. It showed that it is no effect of the maternal age on the clinical pregnancy rate after blastocyst transfer. It may be cancelled if the patient was no blastocyst. But the blastocyst should be transferred whether there is good-quality blastocyst or not.