应用形态学及动力学参数筛选优质囊胚的研究进展

Screening High Quality Blastocyst by Morphological and Kinetic Parameters

囊胚的质量在选择性单囊胚移植(elective single blastocyst transfer,e SBT)中至关重要,移植1个优质的囊胚,可以有效降低多胎率并保持较高的临床妊娠率。目前,囊胚质量的评价方法仍以形态学为主。传统的形态学评分法对各形态学参数进行综合评分,得分高的囊胚质量较优。但当有2个以上综合评分相同的囊胚可供移植时,需要新的指标来选择出最具有发育潜力者。研究显示,囊胚的3个相互独立的形态学参数:内细胞团(inner cell mass,ICM)、滋养层(trophectoderm,TE)和囊胚扩张程度三者对妊娠结局的预测价值不同,可以为囊胚的进一步筛选提供参考。近年来,应用延时(time-lapse)成像技术可以动态观察胚胎发育的全过程,原核期、卵裂期以及囊胚期的动力学参数成为了囊胚质量评价的新指标。综述应用形态学及动力学参数筛选优质囊胚的研究进展。

The blastocyst quality is very important for the elective single blastocyst transfer （eSBT）. Themultiple pregnancy rate can be effectively reduced, and the clinical pregnancy rate can be kept at a higher level,by transplanting a high-quality blastocyst. At present, the main method to evaluate the quality of blastocysts ismorphology. The morphological parameters were comprehensively scored by the traditional morphological scoringmethod, which means that the blastocyst with higher score is of the better quality. However, when there are morethan two blastocysts with the same score, new indicators are necessary for embryologists to select the blastocystwith the most developmental potential for transplantation. Three independent morphological parameters ofblastocyst, inner cell mass （ICM）, trophectoderm （TE） and degree of blastocyst expansion with the differentpredictive value for the pregnancy outcomes, can provide additional references for the further screening of theblastocyst. In recent years, the whole process of embryonic development can be observed dynamically by time -lapse imaging technology. The kinetic parameters of pronuclear stage, cleavage stage and blastocyst stage weretried as the new index for evaluating the quality of embryo. In this article, we reviewed the research progress onthe screening high quality blastocyst by morphological and kinetic parameters.