受精第3天胚胎卵裂速度和囊胚发育潜能的关系

Relationship between embryo cleavage rate on day 3 of fertilization and blastocyst development potential

目的探讨受精第3天胚胎卵裂速度是否可以预测囊胚发育潜能及辅助生殖临床结局。方法回顾性分析2016年1月1日至2018年12月31日于我中心行体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的150例不孕症患者的临床资料及所有366枚新鲜囊胚移植的胚胎数据。根据受精第3天卵裂球的细胞数目将胚胎分为慢发育组(细胞数目≤6个,n=78)、正常发育组(细胞数目7~9个,n=230)和快发育组(细胞数目≥10个,n=58)。分析比较3组的囊胚形成率、优质囊胚形成率、胚胎种植率、临床妊娠率及活产率。结果慢发育组、正常发育组和快发育组囊胚形成率分别为7.7%(6/78)、55.7%(128/230)和29.3%(17/58),其中正常发育组的囊胚形成率最高,与其他两组比较差异均有统计学意义(P均<0.01);3组优质囊胚形成率分别为0(0/6)、7.0%(9/128)和11.8%(2/17),其中快发育组最高,与正常发育组比较差异有统计学意义(P<0.05);胚胎种植率分别为0(0/18)、50.6%(80/158)和63.3%(19/30),其中快发育组最高,与正常发育组比较差异有统计学意义(P<0.05)。正常发育组临床妊娠率为53.7%(58/108)、活产率为41.4%(24/58);快发育组临床妊娠率为63.0%(17/27),活产率为47.1%(8/17);正常发育组与快发育组临床妊娠率和活产率比较差异均有统计学意义(P均<0.05)。结论受精第3天细胞数目7~9的卵裂胚囊胚形成率最高,细胞数目≥10的卵裂胚优质囊胚形成率、胚胎种植率、临床妊娠率及活产率较高,提示快速发育的胚胎有正常的发育潜能。

Objective To investigate whether the embryo cleavage rate on day 3 of fertilization can predict the blastocyst development potential and clinical outcome of assisted reproduction.Methods The embryo implantation data of 366 fresh blastocysts and the clinical data of 150 infertility patients undergoing in vitro fertilization or intracytoplasmic single sperm injection-embryo transfer(IVF/ICSI-ET)in our center from Jan.1,2016 to Dec.31,2018 were retrospectively analyzed.According to the cell number of the blastomere on the third day of fertilization,embryos were divided into slow development group(≤6 cells,n=78),normal development group(7-9 cells,n=230)and fast development group(≥10 cells,n=58).The blastocyst formation rate,high quality blastocyst formation rate,embryo implantation rate,clinical pregnancy rate and live birth rate of the 3 groups were compared.Results The blastocyst formation rates of the slow,normal and fast development groups were 7.7%(6/78),55.7%(128/230)and 29.3%(17/58),respectively,and the normal development group had the top rate,with significant difference when comparing with those in the other two groups(both P<0.01);the high quality blastocyst formation rates of the 3 groups were 0(0/6),7.0%(9/128)and 11.8%(2/17),respectively,and the highest rate was found in the fast development group,with significant difference when comparing with that in the normal development group(P<0.05);the embryo implantation rates of the 3 groups were 0(0/18),50.6%(80/158)and 63.3%(19/30),respectively,and the highest rate was found in the fast development group,with significant difference when comparing with that in the normal development group(P<0.05);the clinical pregnancy rate and live birth rate were 53.7%(58/108)and 41.4%(24/58)in the normal development group,and were 63.0%(17/27)and 47.1%(8/17)in the fast development group,respectively;there were significant differences in clinical pregnancy rate and live birth rate between the normal and fast development groups(both P<0.05).Conclusion The cleavage embryos with 7-9 cells on day 3 of fertilization have the highest blastocyst formation rate,and cleavage embryos with≥10 cells on day 3 have much higher rates of high quality blastocyst formation,embryo implantation,clinical pregnancy and live birth,suggesting that fast development embryos have normal development potential.