人合子原核构型及早期卵裂与胚胎发育潜能的关系

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1、人合子原核构型及早期卵裂与胚胎发育潜能的关系作者：李瑞文滕文顶鲜红周瑞年【摘要】目的:探讨胚胎早期卵裂及原核构型能否指导移植胚胎的选择及与胚胎发育潜力之间的关系。方法:根据早期卵裂时间及原核构型不同进行筛选而移植的129个体外受精(IVF)、卵胞浆内单精子注射(ICSI)周期，共1032个正常受精卵为资料。根据受精卵原核构型的不同分为四组，结合构型类型及早期卵裂与否进行选择性移植，通过观察优质胚胎率、囊胚形成率、种植率和怀孕率，来评估合子原核构型和早期卵裂与胚胎发育潜力的关系。结果:最常见的原核构型为PN1(29.58%)及PN2(27.67%)，接着是PN3(2

2、2.38%)和PN4(20.37%)，而且这些构型与受精方式及精子穿卵的位点无关;与其它种类的原核构型相比，源于PN1和PN4原核构型的合子发育到优质胚胎及囊胚的比例显著增高(P<0.05);PN1和PN4原核构型的合子发育成的胚胎，其种植率和怀孕率亦显著升高(P<0.05);早期卵裂胚胎与晚卵裂胚胎相比，发育到优质胚及囊胚的胚胎数与种植率、怀孕率均显著增高(P<0.05)。结论:合子原核构型与胚胎早期卵裂时间能够指导移植胚胎的选择，对种植率及怀孕率的提高有一定的临床意义。【关键词】人;合子;原核构型;早期卵裂;胚胎发育14　　【ABSTRACT

3、】Objective:Toevaluatetherelationshipbetweenembryoearlycleavage,pronucleiorientationandembryodevelopmentpotential,andinvestigatewhetheritisusefultoselecttheembryothatwillbetransfered.Methods:Inthisretrospectivestudy,atotalof1032normalzygotes(twopronuclei)from129treatmentcycleswithIVF/I

4、CSIwereanalyzed.Thesezygotesweredividedintofourgroupsaccordingtothedifferentzygotepronucleiorientationandthedevelopmentalpotential.Earlycleavagerate,embryoquality,therateofblastocyst,implantationandpregnantratesfromthesezygoteswereobserved,andthetransferredembryoswereselectedaccording

5、tothepronucleiorientationandearlycleavagetime.Results:ThemostcommontypesofpronucleiwerePN1(29.58%)andPN2(27.67%),followedbyPN3(22.38%)andPN4(20.37%),andthiswasindependentfromthefertilizingspermatozoonoritsentrypointintotheoocytes;AsignificantlyhigherproportionofzygoteswithPN1andPN4typ

6、esofpronucleiorientationunderwentearlycleavageanddevelopedintogradeⅠembryosandblastocystscomparedwithothertypes(P<0.05);theimplantationandpregnancyratesamongpatientswhoreceivedembryosdevelopedfromPN1andPN4typesoocyteswerehighersignificantly(P<0.05).Comparedwasthat14oflatercleav

7、agedembryo,thenumberofdevelopmentintogradeⅠ,theblastocystrates,implantationandpregnantratesofearlycleavagedembryowerehighersignificantly(P<0.05).Conclusion:Thezygotepronucleiorientationandthetimeofembryoearlycleavageareusefulfortheselectionofembryototransfer,itmayprovideabetterguid

8、etoth