胚胎发育动力学参数与胚胎种植率的关系

Relationship between embryo dynamic parameters and embryo implantation rate

目的:探讨胚胎发育动力学参数与胚胎种植率之间的关系,旨在为选择种植率更高的胚胎提供依据。方法:回顾性分析利用EmbryoScopeTimelapse胚胎培养系统进行培养和监测的316个常规体外受精周期,其中种植率为0%者(未种植组)146例,种植率为100%者(种植组)170例,对两组共601枚胚胎进行动力学分析,比较两组胚胎动力学参数的差异。用四分位分析法对胚胎发育的每个时间段进行分析,找出种植率最高的优势时间段。结果:种植组胚胎授精至原核出现时间(tPNa)、授精至原核消失时间(tPNf)、授精至二细胞时间(t2)、授精至三细胞时间(t3)、授精至四细胞时间(t4)、授精至六细胞时间(t6)、授精至七细胞时间(t7)、授精至八细胞时间(t8)、s2(t4-t3)均短于未种植组(P<0.05)。1.94h≤tPNa<7.73h、15.53h≤tPNf<21.08h、17.87h≤t2<23.59h、22.15h≤t3<36.52h、25.87h≤t4<37.63h、31.52h≤授精至五细胞时间(t5)<53.66h、32.58h≤t6<55.37h、33.58h≤t7<57.20h、40.88h≤t8<59.71h、0.18h≤s2<1.23h更有利于胚胎种植,其中15.53h≤tPNf<21.08h和17.87h≤t2<23.59h种植率均高于其他3个时间段(P<0.001)。结论:胚胎发育进程快的胚胎种植率高;15.53h≤tPNf<21.08h、17.87h≤t2<23.59h有利于胚胎种植。

Aim :To study relationship between embryo dynamic parameters and embryo implantation rate for the selection of embryos for transfer in clinical practice. Methods :A total of 601 embryos of 316 in vitro fertilization cycles(146 cycles were 0% implantation and 170 cycles were 100% implantation) cultured in an incubator with EmbryoScope Timelapse system were retrospectively analysed. The time period of embryo development was analyzed with the method of quartile analysis to find the dominant time period with the highest planting rate. Results :Insemination to pronucleus appearance time(tPNa), insemination to pronucleus disappearance time(tPNf), insemination to two cells time(t2), insemination to three cells time(t3), insemination to four cells time(t4), insemination to six cells time(t6), insemination to seven cells time(t7), insemination to eight cells time(t8), and s2(t4-t3) of planting group were significantly lower than those of non-planting group( P <0.05).1.94 hours≤tPNa<7.73 hours,15.53 hours≤tPNf<21.08 hours,17.87 hours≤t2<23.59 hours,22.15 hours≤t3<36.52 hours, 25.87 hours≤t4<37.63 hours, 31.52 hours≤insemination to five cells time(t5)<53.66 hours,32.58 hours≤t6<55.37 hours,33.58 hours≤t7<57.20 hours,40.88 hours≤t8<59.71 hours,0.18 hours ≤s2<1.23 hours had better implantation rate.When 15.53 hours≤tPNf<21.08 hours,17.87 hours≤t2<23.59 hours,the planting rates were significantly higher than those of the other three periods( P <0.001). Conclusion :Embryos with rapid development have higher implantation rate.The most predictive parameters for implantation are 15.53 hours≤tPNf<21.08 hours and 17.87 hours≤t2<23.59 hours.