对废弃胚胎行囊胚培养在体外受精-胚胎移植中的意义

摘要

Objective To explore the potential use of discarded embryos for in vitro fertilization- embryo transfer (IVF- ET). Methods The discarded embryos from d3 were cultured into blastula by the sequential culture method. Results A total of 1962 discarded embryos from 782 patients were cultured, in which 376 blastocysts were formed with a blastocyst rate of 19.2%. The blastocyst formation rates were significantly higher from 1PN, 0PN and>6 cells embryos. The clinical pregnancy rate in women with blastosphere formed was significantly higher than those without blastosphere formed. Sixty four blastocysts were formed for 2PN,10 of which were transferred while the others were frozen. The clinical pregnancy rate of blastocyst transfer was 66.7%. Thir-teen women got pregnant in 24 frozen- thawed blastocyst transfer cycles. A total of 18 healthy babies were born from blastocyst transfer. Conclusion The discarded embryos have different development potential.They can develop into biastospheres. Blas-tocyst from appropriate discarded embryos can improve the utilization rate of embryos.%目的：探讨对不可移植的废弃胚胎行囊胚培养在体外受精-胚胎移植（IVF- ET）中的意义。方法通过囊胚序贯培养法将d3废弃胚胎培养至囊胚期。比较不同来源胚胎及d3胚胎的卵裂球数与囊胚形成的关系；利用废弃胚胎囊胚形成情况对体外受精妊娠结局进行预测；并将获得的可移植囊胚行胚胎移植及冷冻。结果共收集782例患者的1962个废弃胚胎，经序贯培养，形成囊胚376枚（19.2%）；1PN胚胎、0PN胚胎、d 3卵裂球数＞6的胚胎囊胚形成率较高（均P＜0.05）；废弃胚胎中有囊胚形成者的临床妊娠率明显高于无囊胚形成者（P＜0.05）；由2PN胚胎形成囊胚共64枚，其中10枚囊胚行移植，剩余囊胚行玻璃化冷冻保存，囊胚移植后临床妊娠率66.7%。解冻移植囊胚24个周期，妊娠周期13个，妊娠率54.2%。囊胚移植共获得健康婴儿18名。结论IVF- ET中废弃胚胎部分可发育为囊胚，选择合适的胚胎行囊胚培养，能获得部分可用胚胎，提高胚胎利用率。