受精卵质量评估在体外受精胚胎发育潜能及临床妊娠率预测中的应用价值

摘要

目的探讨体外受精周期受精卵原核评级及胞浆晕出现与否在预测胚胎体外发育潜能及临床妊娠率的应用价值.方法回顾性分析618例体外受精周期D1受精卵原核评级及胞浆晕出现情况与卵裂率、D3可冻胚胎率、D3优质胚胎率、囊胚转化率、可冻囊胚转化率、优质囊胚转化率及临床妊娠结局的关系.结果D1受精卵原核评级为Z1、Z2、Z3组的D3卵裂率、D3优质胚胎率、囊胚转化率、可冻囊胚转化率均高于Z4组受精卵且差异有统计学意义(P＜0.05);受精卵原核评级Z1组囊胚转化率高于Z3组且差异有统计学意义(P＜0.05);受精卵胞浆晕出现组胚胎发育参数高于无胞浆晕出现组且差异有统计学意义(P＜0.05);原核评级为Z1、Z2、Z3的受精卵胞浆晕出现组胚胎发育参数高于无胞浆晕出现组且差异有统计学意义(P＜0.05),但原核评级为Z4的受精卵有胞浆晕组仅D3优质胚胎率高于无胞浆晕组且差异有统计学意义(P＜0.05);D3移植周期中,移植胚胎胞浆晕出现与否在不同分组间的临床妊娠率及胚胎种植率差异无统计学意义(P＞0.05).结论体外受精周期受精卵原核评级及胞浆晕出现与否可以用于预测胚胎体外发育潜能,但移植胚胎胞浆晕出现与否无法预测胚胎种植及临床妊娠率.%Objective To explore the application value of the pronuclear morphology score and the presence of cytoplasmic halo in predicting the embryonic development potential and clinical pregnancy rate.Methods In this retrospective study, 618 cases zygotes were assessed according to pronuclear scoring systems and checked for the formation of cytoplasmic halo.The embryo cleavage rate, day 3 frozen embryo rate, day 3 high-quality embryo rate, blastocyst formation rate, frozen blastocyst formation rate, high-quality blastocyst formation rate and the clinical pregnancy outcome were analyzed.Results The day 3 embryo cleavage rate, high-quality embryo rate, blastocyst formation rate, and frozen blastocyst formation rate were significantly higher in Z1, Z2, Z3 zygotes than in Z4 zygotes (P＜0.05).The blastocyst formation rate of Z1 was significantly higher than that of Z3 (P＜0.05).Compared with those in halo-negative zygotes, the embryonic development parameters were significantly higher than those in halo-positive zygotes (P＜0.05).The embryonic development parameters of halo-positive Z1, Z2, Z3 zygotes were significantly higher than those of halo-negative Z1, Z2, Z3 zygotes (P＜0.05), however, only the day 3 high-quality embryo rate was significantly higher in the halo-positive Z4 zygotes than in the halo-negative Z4 zygotes (P＜0.05).Whether Day3 embryos appeared or not, a halo at zygote stage was not significantly different in the clinical pregnancy rate and implantation rate (P＞0.05).Conclusion Pronuclear morphology score and the presence or absence of cytoplasmic halo can indicate the developmental potential of embryo in vitro, but the cytoplasmic halo can not predict the embryo implantation and clinical pregnancy rate effectively.