D3胚胎卵裂球数目与胚胎发育潜能和整倍性的相关性研究

Relationship between number of blastomeres in Day 3 embryos and prediction of embryonic developmental potential and euploidy

目的通过高通量测序技术(NGS)探讨D3胚胎卵裂球数目与胚胎发育潜能和整倍性之间的关系。方法回顾性分析2018年1月至2021年12月于本院生殖中心行胚胎植入前非整倍体遗传学检测(PGT-A)助孕的261个治疗周期共920枚活检囊胚的数据资料,根据D3胚胎卵裂球数目不同进行分组(4细胞组、5细胞组、6细胞组、7细胞组、8细胞组、9细胞组、10细胞组及≥11细胞组),评估各组后续获得优质囊胚和整倍体囊胚的机会,并统计分析各组间临床结局的差异。结果(1)与8细胞组相比,5细胞、6细胞、7细胞及10细胞组优质囊胚率显著降低(P=0.00),调整女方年龄因素以后,差异仍有显著性(P=0.00);卵裂球数目合并分组后,≤7细胞组、9~10细胞组的优质囊胚率显著低于8细胞组,调整年龄因素以后,差异仍有显著性(P<0.05);≥11细胞组优质囊胚率与8细胞组间无显著性差异(P=0.51),调整女方年龄后,仍无显著性差异(P=0.45)。(2)与8细胞组相比,其他各组囊胚的整倍体率均无显著性差异(P>0.05);调整年龄后,各组间囊胚整倍体率仍无显著性差异(P>0.05);卵裂球数目合并分组后,各组间随着卵裂球发育速度增快,囊胚整倍体率增加,但差异尚无统计学意义(P>0.05);调整年龄混杂因素后,各组间的囊胚整倍体率仍无显著性差异(P>0.05)。(3)随着卵裂球数目增加,各组临床妊娠率、活产率呈上升趋势;卵裂球数目合并分组后,≥11细胞组的临床妊娠率和活产率最高,≤7细胞组的临床妊娠率和活产率最低,但差异均尚无统计学意义(P>0.05)。结论D3卵裂期胚胎的发育潜能随着卵裂球数目的增加而增加,≥11细胞的D3快速分裂胚胎具有同8细胞胚胎相似的整倍体率和活产率,为临床单胚胎移植胚胎选择策略提供一定的参考。

Objective:To investigate the relationship between the blastomeres number of embryos on Day 3 and the developmental potential and euploidy of embryos by high-throughput sequencing technology(Next generation sequencing,NGS).Methods:The data of 920 biopsied blastocysts in 261 cycles of preimplantation genetic testing for aneuploidy(PGT-A)at the reproductive center of our hospital from January 2018 to December 2021 were retrospectively analyzed.The biopsied blastocysts were grouped according to the blastomeres number of embryos on Day 3(4 cells,5-cell,6-cell,7-cell,8-cell,9-cell,10-cell,and≥11 cells groups).The chances of obtaining high-quality blastocysts and euploid blastocysts in each group were evaluated,and the clinical outcomes of each group were analyzed.Results:(1)Compared with the 8-cell group,the high-quality blastocyst rates in 5-cell,6-cell,7-cell and 10-cell groups were significantly lower(P=0.00),and the difference was still significant after the age-factor adjustment(P=0.00).After the number of blastomeres was merged and grouped,the rate of high-quality blastocysts in the≤7 cell and 9 to 10 cell groups was significantly lower than that in the 8-cell group,and the difference was still significant after adjusting the age factor.The high-quality blastocyst rate in the≥11 cell group was not significantly different from that in the 8-cell group(P=0.51),and the difference was not significant after adjusting the age factor(P=0.45).(2)Compared with the 8-cell group,there was no significant difference in the euploid rate of blastocysts among the other groups(P>0.05),and the difference was still not significant after adjusting the age factor(P>0.05).After the number of blastomeres was merged and grouped,the euploid rate of blastocysts increased with the increase of blastomere development speed among each group,but the difference was not statistically significant(P>0.05).(3)As the number of blastomeres increased,the clinical pregnancy rate and live birth rate among the groups showed an upward trend.After the number of blastomeres was merged and grouped,the clinical pregnancy rate and live birth rate were the highest in≥11 cell group,and the clinical pregnancy rate and live birth rate was lowest in≤7 cell group.However,the differences were not statistically significant(P>0.05).Conclusions:The developmental potential of Day 3 cleavage-staged embryos increases with the increase of the number of blastomeres,and Day 3 rapidly cleavage embryos with≥11 cells exhibit similar euploid rate and live birth rate to 8-cell embryos.This study provides a certain reference for the selection strategy of clinical single embryo transfer embryos.