早期原核分裂对于胚胎发育潜能预测的研究

Early pronuclear cleavage is an indicator of embryo development potential

目的通过比较移植早期原核与晚期原核分裂胚胎的临床妊娠率和种植率,探讨早期原核分裂与胚胎发育潜能之间的关系。方法回顾性分析05年11月至07年1月在生殖医学中心行体外受精胚胎移植的妇女240例,通过移植不同时期的原核分裂胚胎将其分为早期原核分裂组(143例),晚期原核分裂组(47例)和混合组(50例),比较三组的妊娠率和种植率。结果早期原核分裂组的受精率和早卵裂率分别为80.39%和54.16%,而晚期原核分裂组的受精率和早卵裂率分别为71.01%和8.99%,差异具有统计学意义(P<0.001)。早裂组的妊娠率(47.55%)高于晚裂组的妊娠率(38.30%),差异具有统计学意义(P<0.001)。种植率前者为29.72%,高于后者(22.99%),差异无统计学意义(P>0.05)。结论早期原核分裂有更好的妊娠结局,能够预测胚胎发育潜能,评价早期原核分裂是筛选高质量胚胎的一种简单有效、非侵袭性方法 。

Objective To assess the relationship between early pronuclear cleavage and embryo development potential. Methods A retrospective analysis was carried out in 240 IVF/ICSI cycles during November 2005 to January 2007 in IVF Centre. The early pronuclear cleavage group （n = 143 ）, the late pronuclear cleavage group （n = 47 ） and the mixed group（ n = 50） were classified based on cleavage stage of transferred embryos. Clinical pregnancy rate and implantation rate were evaluated. Result The early pronuclear cleavage group had a higher fertilization rate and early cleavage rate （80.39% and 54.16% ） compared with the late pronuclear cleavage group （71.01% and 8.99% ）, the difference was statistically significant（ P 〈 0.001 ）. The transfer of early cleavage embryos resulted in a significantly higher clinical pregnancy rate than those with late cleavage group （47.55% vs. 38.30% ）. There was no significant difference in implantation rate between early group and late group （29.72% vs 22.99%, P 〉 0.05 ）. Conclusion Early pronuclear breakdown is a strong indicator of embryo viability, and may be used as an additional criterion in the selection of embryos for transfer.