合子形态与胚胎种植潜能关系的初探

Relationship between the human zygote type and embryo implantation potential

目的 :通过对体外受精获得的人合子进行Tesarik合子分型 ,探讨合子分型与受精后胚胎质量、胚胎种植率、多胎率的关系。方法 :对 2 0 0 1年 11月至 2 0 0 2年 3月因各种原因的不孕行体外受精胚胎移植治疗 (IVF ET)患者的 2 2 6个胚胎 (实验组 ) ,应用NikonTE3 0 0倒置光学显微镜 ,对体外受精的人合子及受精后D3的胚胎进行形态学观察 ,并进行Tesarik合子分型和胚胎分级 ,了解各型合子发育成优质胚胎的比率。 2 2 6个胚胎中 198个来自通过常规体外受精 (invitrofertilization ,IVF)方法发育来的胚胎 ,2 8个来自通过单精子胞浆内注射方法 (intracyto plasmicsperminjection ,ICSI)受精发育来的胚胎。以D3优质胚胎标准及合子分型双重标准选择移植胚胎 ,即当有多个D3优质胚胎可供移植时 ,选择移植 0型合子发育而来的优质胚胎。与 2 0 0 0年 10月至 2 0 0 1年 10月单纯使用D3优质胚胎标准选择移植胚胎的患者 (对照组 )进行比较 ,总结两组胚胎种植率 ;比较单纯 0型合子优质胚胎与单纯非 0型合子优质胚胎的种植率 ;探讨 0型合子优质胚胎移植数与多胎率的关系。结果 :由 0型和非 0型合子发育成D3优质胚胎的比率差异无显著性。加入合子分型作为选择胚胎的标准后实验组胚胎种植率明显高于对照组 ,差异有显著性。

Objective: To evaluate the relationship between the human zygote types and the quality of embryos, the embryo implantation rate, the multiple pregnancy rate in IVF ET. Methods:By using the criteria based on the number and distribution of nucleolar precursor bodies in each pronucleus, zygotes were divided into 0-5 types according to Tesarik's methods. In order to understand the best embryo rates that came from various types of zygote,on the one hand we compared the embryo implantation rate of different kinds of zygotes,on the other hand we defined the relationship between the multiple pregnancy rate and embryo which came from 0 type or non 0 type zygotes. Results: The fine embryo rate coming from 0 type zygotes wasn't different from other types. Due to using of 0 type zygote criteria,embryo implantation rate of the experimental group was high. Along with the embryo number coming from 0 type zygotes was growing, the multiple pregnancy rate was increasing. Conclusion: Fine embryos coming from 0 type zygotes have high implantation potency. If the transferred fine embryos came from 0 type zygotes completely, we should limite the number of transferred embryos in order to reduce the multiple pregnancy rate.