原核期形态特征与胚胎体外发育能力和体内着床潜能的关系.docVIP

原核期形态特征与胚胎体外发育能力和体内着床潜能的关系 刘 群，胡 娟，任新玲，魏玉兰，吴 黎，靳 镭，李豫峰，朱桂金，艾继辉 （430030，武汉，华中科技大学同济医学院附属同济医院妇产科） [摘要] 目的 探讨原核期评分系统与受精后第3天胚胎形态、受精后第6天囊胚形成和着床率之间的关系，以评估其在体外授精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）中的应用价值。方法 于常规IVF或ICSI授精后16～20 h观察受精情况，将正常受精卵母细胞参照Scott提出的Z评分系统分为Z1-Z4四种类型，比较不同原核类型之间的卵裂率，D3优质胚胎率和D6囊胚形成率。并通过分析着床结局明确的移植胚胎，比较各种类型受精卵之间的着床率。 结果 Z4组受精卵的卵裂率（92.9%）、D3优质胚胎率（14.25%）、D6囊胚形成率（10.48%）均明显低于其他各组（P0.01）。Z4组的着床率（5.88%）很低，但各组的着床率之间差异无显著性（P＞0.05）。Z1、Z2、Z3三组间的卵裂率、D3优质胚胎率、D6囊胚形成率和着床率之间差异均无统计学意义（P＞0.05）。结论 异常的原核形态（Z4型）可预测胚胎的体内外发育潜能，但核仁的形态特征并不一定能预测胚胎的活力，Z1，Z2和Z3胚胎可能具有相同的发育潜能。 [关键词] 体外授精-胚胎移植；胚胎质量；囊胚形成；着床能力；原核评估 [中图法分类号] R711.6 [文献标志码] A Effects of Pronuclear Morphological Characteristics on in-vitro Development and Implantation Potential in IVF-ET Liu Qun, Hu Juan, Ren Xinling, Wei Yulan, Chen Wen, Wu Li, Jin Lei, Li Yufeng, Zhu Guijin, Ai Jihui (Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030) [Abstract] Objective To assess the relationship between pronuclear scoring and day-3 embryo quality and day-6 blastocyst rate and implantation rate to determine the clinical value of pronuclear stage scoring system in human in vitro fertilization-embryo transfer (IVF-ET) program. Methods A pronuclear scoring system was used to score zygotes 16 - 20 hours after insemination during conventional IVF or intracytoplasmic sperm injection (ICSI). The embryos were classified into group Z1, Z2, Z3 and Z4. Comparisons were made of the rates of cleavaged embryos and excellent embryos on day 3 and blastocyst on day 6. Comparisons of implantation rate were made between the transferred embryos which had the proven implantation behavior. Results There were less cleavaged embryos (92.9%，P0.001) and less excellent embryos on day 3 (14.25%，P0.001)and less blastocysts on day 6 (10.48%，P0.01) in group Z4 than those in group Z1, Z2 and Z3. There were no statistical differ