卵裂方式对胚胎发育潜能影响.docVIP

卵裂方式对胚胎发育潜能影响 　　【摘要】目的： 探讨常规体外受精（IVF）后胚胎的卵裂方式对于胚胎发育潜能的影响，为优化胚胎筛选流程提供参考。方法：回顾性分析250例常规IVF周期的患者资料，通过时差成像技术（Time-lapse imaging，TLI）进行胚胎培养及动态观察胚胎的卵裂模式，其中2850枚非移植胚胎行囊胚培养。以囊胚质量为结局进行Logistic回归分析，建立优质胚胎的筛选标准。结果：回顾性分析显示，分裂方式为正常卵裂、不均、非轴性卵裂的胚胎具有较高的优质囊胚形成率（分别为5729%、4650%及4182%），大碎片、发育阻滞、非二倍性卵裂、非对称卵裂、卵裂球碎裂、卵裂球融合及混合卵裂模式的胚胎，其优质囊胚形成率较低（P005，vs 正常卵裂组），可作为胚胎筛选的排除标准。结论：卵裂方式有助于预测胚胎发育潜能，提高胚胎挑选的效率，也为传统的静态形态学胚胎评估予以提示。 　　【关键词】时差成像技术；卵裂方式；胚胎评估 　　Influence of cleavage pattern on the potential of embryonic developmentWANG Shanshan， ZHAO Xia， NI Xiaobei， SUN Haixiang. Reproductive Medicine Center， Affiliated Drum Tower Hospital of Nanjing University Medical School， Nanjing 210008， China 　　【Abstract】Objectives： To discuss the influence of embryonic cleavage pattern on the potential of embryonic development after conventional in vitro fertilization （IVF）， and to provide a reference for optimizing the embryo screening process. Methods： A retrospective analysis on the data of 250 patients with traditional IVF cycle was done， namely embryos were cultured through time-lapse imaging （TLI） and the cleavage pattern of embryos was dynamically observed， of which blastocyst culture of 2850 non-transplanted embryos was finished. Logistic regression analysis was carried out by taking the quality of blastocysts as the end， and a screening criterion for good-quality embryos was established. Results： Retrospective analysis results showed embryos with normal cleavage， uneven cleavage and non-axial cleavage had high formation rates of good-quality blastocyst （57.29%， 46.50%， and 41.82% respectively）. The embryos with large fragmentation， developmental arrest， non-diploid cleavage， dissymmetric cleavage， fragmented blastomere， cell-cell fusion and mixed patterns had low formation rates of good-quality blastocyst （P 005，vs. normal cleavage group）， and thus could be used as an exclusion criterion for embryo screening. Conclusion： The cleavage pattern helps to predict the embryonic development potential， impro