目的 探讨体外受精(IVF)治疗中D3低质量胚胎培养至囊胚的发育潜能,为囊胚的培养和冷冻提供依据.方法 2010年6～12月进行IVF治疗的患者 398例,D3移植后剩余的总胚胎数2,180枚.其中形态学较低质量胚胎1,546枚,采用序贯法微滴培养,D3～D6连续观察囊胚形成情况,比较不同细胞数、碎片含量不同的胚胎囊胚形成的比例.结果 1,546枚低质量胚胎,于D5～D6形成426枚囊胚,囊胚形成率为27.56%.其中6 Ⅲ、Ⅳ级为40.9%(318/778);5Ⅰ、Ⅱ级为28.8%(30/104);4Ⅰ、Ⅱ级为8.9%(16/180),4Ⅲ、Ⅳ级为19.7%(56 /284);2～3Ⅰ、Ⅱ级为3.0%(6/200).经统计学分析,碎片较多的胚胎中,卵裂球数目较多的胚胎,囊胚形成率较高.结论 D3形态学较低质量胚胎仍有部分具有发育至囊胚的潜能,因此在D3时对这些胚胎继续进行培养至D6,可能减少胚胎的浪费并得到更好临床结局.%Objective: To investigate the potential of in vitro blastocyst development for D3 low quality embryos and serve blastocyst culturing and freezing.Methods: The 2,180 embryos were obtained after D3 embryo transfer in 398 patients who underwent IVF / ICSI cycles.The 1,546 low-quality embryos were cultured by using sequential micro-drops, and the blastocyst formation was continuously observed from D3 to D6.Results: (1) The total low-quality embryos were 1,546, and 426 blastocysts formed in the D5 - D6.Total blastocyst formation rate was 27.56％, 6 Ⅲ/Ⅳ were 40.9％ (318/778), 5 Ⅰ / Ⅱ 28.8％(30/104), 4Ⅰ/Ⅱ 8.9％ (16/180),4 Ⅲ/Ⅳ 19.7％ (56 /284),2-3 Ⅰ/Ⅱ 3.0％ (6/200).(2)The more embryonic blastomeres the more blastocyst formation.The lower quality embryos resulted in lower blastocyst formation rate.Conclusions: Low-quality embryos on D3 still have the potential to develop into blastocysts.Therefore, they should not be discarded on D3.We had better continually to culture them to D6.It can reduce embryo wastage and receive good clinical results.
展开▼
