体外受精胚胎发育潜能的形态学评估

Morphological evaluation of human embryo developmental potential in in vitro fertilization

随着体外受精-胚胎移植（IVF—ET）技术的不断进步，如卵巢刺激方案和胚胎培养技术的革新，已促使妊娠率大幅度提高，而伴随的多胎妊娠率也升高。多胎妊娠危及母婴的安全，有悖于优生原则。减少移植胚胎的数目，推行单胚胎移植是降低多胎出生最为有效的措施，但困扰胚胎学家的是如何选择最具有发育潜能的胚胎用于移植。目前，胚胎体外发育潜能的评估方法仍主要依据胚胎形态学的评分，

Multiple birth is the biggest risk to the health and welfare of children born after IVF. Reduction the number of embryos transferred is effective strategy to reduce the incidence of multiple pregnancies after IVF. However, the main problem is how to select the best quality embryo for transfer. Currently, the morphological scoring continues to be the primary tool for embryo selection and transfer. Throughout pre-implantation development, embryos must undergo a series of critical events, i. e. , the fertilization process, the first mitotic divisions, the activation of the embryonic genome, and blastomere compaction and cavitation, ending with the formation of an expanded blastocyst. The embryo development is usually companied with one or more atypical morphology in vitro, such as fragmentation, uneven blastomeres, low or fast development rate, multi-nucleation of blastomere, vacuoles. Atypical development may indicate the low development potential of human embryo. Recently, a method of sequential morphological scoring for embryo selection has been recommended. Taking into account many morphological parameters of different stages of embryo will help us to select the embryos of higher developmental potential.