卵裂期胚胎发育速度对体外受精-胚胎移植临床结局的影响

Effect of cleavage stage embryonic development rate on clinical outcomes of in vitro fertilization-embryo transfer

目的 探讨不同发育速度的卵裂期胚胎对后续囊胚培养及移植后结局的影响。方法 回顾性分析2020年1月至2023年7月于该院生殖中心行体外受精-胚胎移植/卵胞浆内单精子注射助孕的患者资料,根据第3天胚胎卵裂球数目分为6~10个细胞组及11~16个细胞组。其中6~10个细胞组又分为6个细胞组、7个细胞组、8个细胞组、9个细胞组和10个细胞组;11~16个细胞组又分为11~12个细胞组、13~14个细胞组和15~16个细胞组。比较各组的囊胚培养情况和移植后的临床结局。结果 11~16个细胞组的非二倍卵裂率和卵裂球碎裂率明显高于6~10个细胞组,差异有统计学意义(P<0.05)。6~10个细胞组的囊胚形成率和优质囊胚率均明显低于11~16个细胞组,差异均有统计学意义(P<0.05);2组临床妊娠率、胚胎种植率、流产率、活产率和抱婴回家率比较,差异均无统计学意义(P>0.05)。在6~10个细胞各亚组中,6个细胞组的囊胚形成率明显低于其他各组,差异有统计学意义(P<0.05);7个细胞组的囊胚形成率明显低于8个细胞组、9个细胞组、10个细胞组,差异有统计学意义(P<0.05);6个细胞组和7个细胞组的优质囊胚率明显低于8个细胞组、9个细胞组、10个细胞组,差异有统计学意义(P<0.05);各组间的临床妊娠率、胚胎种植率、早期流产率、活产率和抱婴回家率比较,差异无统计学意义(P>0.05)。在11~16个细胞各亚组中,3组的囊胚形成率、优质囊胚率、临床妊娠率、胚胎种植率、流产率、活产率和抱婴回家率比较,差异均无统计学意义(P>0.05)。结论 发育速度较快的11~16个细胞胚胎可形成高质量囊胚,移植后可获得较好的临床结局。

Objective To investigate the effects of cleavage stage embryos with different development rates on subsequent blastocyst culture and clinical outcomes after transfer.Methods The clinical data of the patients with in vitro fertilization-embryo transfer/intracytoplasmic sperm injection assisted pregnancy in the Reproductive Center of this hospital from January 2020 to July 2023 were analyzed retrospectively.They were divided into the 6-10 cells group and 11-16 cells group according to the number of embryonic blastomeres on 3 d.The 6-10 cells group was divided into the 6 cells,7 cells,8 cells,9 cells and 10 cells subgroups.The 11-16 cells group was divided into the 11-12 cells,13-14 cells and 15-16 cells subgroups.The culture situation of blastocyst and the clinical outcomes after transfer were compared among various groups.Results The non-diploid cleavage rate and blastomere fragmentation rate in the 11-16 cells group were significantly higher than those in the 6-10 cells group(P<0.05).The blastocyst formation rate and high quality blastocyst rate in the 6-10 cells group were significantly lower than those in the 11-16 cells group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the clinical pregnancy rate,embryo implantation rate,abortion rate,live birth rate and baby taking home rate between the two groups(P>05).In the 6-10 cells subgroup,the blastocyst formation rate in the 6 cells group was significantly lower than that in the other groups,and the difference was statistically significant(P<0.05).The blastocyst formation rate in the 7 cells group was significantly lower than that in the 8 cells,9 cells and 10 cells groups(P<0.05).The high quality blastocyst rate in the 6 cells and 7 cells groups was significantly lower than that in the 8 cells,9 cells and 10 cells groups,and the differences were statistically significant(P<0.05).There was no statistically significant difference in clinical pregnancy rate,embryo implantation rate,abortion rate,live birth rate and baby taking home rate among all groups(P>0.05).In the 11-16 cells subgroups,there was no statistically significant difference in blastocyst formation rate,high quality blastocyst rate,clinical pregnancy rate,embryo implantation rate,abortion rate,live birth rate and baby taking home rate among the three groups(P>0.05).Conclusion 11-16 cells embryos with faster development rate could form the high-quality blastocysts and achieve better clinical outcomes after transfer.