生殖医学杂志

目的对比D1不同受精状态的胚胎(0PN、1PN、2PN)继续培养后囊胚形成情况,评估异常受精来源胚胎的囊胚形成效果,探讨其可利用价值。方法收集2017年1月至2019年7月在河北省生殖医学中心实施IVF的周期资料,选择形态学评分等同于优质胚胎的异常受精胚胎及2PN来源的优质胚胎,将其培养至囊胚阶段,囊胚评分依据Gardner评分标准。根据D1受精情况分为3组:0PN组(193个)、1PN组(32个)、2PN组(573个);根据胚胎继续发育情况将D2及D3分别分为A、B、C三个亚组:D2亚组:≤3细胞(A1组)、4～6细胞(B1组)和>6细胞(C1组);D3亚组:≤6细胞(A2组)、7～9细胞(B2组)和>9细胞(C2组)。比较各组的囊胚形成率、优质囊胚率及可利用囊胚率。结果 (1)0PN、1PN及2PN 3组整体的囊胚形成率、优质囊胚率、可利用囊胚率均无显著性差异(P>0.05),但3组的囊胚形成情况D5均优于D6(P<0.05)。(2)1PN、2PN两组的D2 4～6细胞亚组(B1组)囊胚形成情况最佳。(3)0PN组D3亚组囊胚形成率B2和C2组优于A2组(P<0.05),可利用囊胚率的顺序为C2>B2>A2(P<0.05);1PN组D3亚组囊胚形成率顺序为B2>C2>A2(P<0.05);2PN组D3亚组可利用囊胚率顺序为C2>B2>A2(P<0.05)。(4)D2≤3细胞亚组(A1组)中囊胚形成情况表明2PN组最佳(P<0.05);C1亚组中囊胚形成情况0PN组最佳(P<0.05)。(5)D3 A2亚组中囊胚情况2PN组最佳(P<0.05)。结论形态学评分优质的0PN、1PN胚胎具有较好的囊胚发育潜能,形成的优质囊胚可能有一定的利用价值。

Objective:To compare the blastocyst formation status from the Day 1 embryos in different fertilization states(0 PN,1 PN,2 PN) after continuous culture, in order to evaluate the effect of abnormal fertilization on blastocyst formation and explore its utilization value.Methods:The data of IVF cycles conducted in Hebei Reproductive Medical Center from January 2017 to July 2019 were collected. The abnormal fertilized embryos with morphological scores equal to good-quality embryos and 2 PN good-quality embryos were collected and cultured to blastocysts. The blastocyst scores were based on Gardner scoring standard. The embryos were divided into three groups according to the different fertilization states: 0 PN group(n=193),1 PN group(n=32),2 PN group(n=573). According to the embryos development status, the embryos were divided into three subgroups: Day 2 subgroup: ≤3 cells(group A1),4-6 cells(group B1) and >6 cells(group C1),Day 3 subgroup: ≤6 cells(group A2),7-9 cells(group B2) and >9 cells(group C2). The blastocyst formation rate, good-quality blastocyst rate and available blastocyst rate of different groups were compared.Results:(1)There was no significant difference in blastocyst formation rate, good-quality blastocyst rate and available blastocyst rate among 0 PN,1 PN and 2 PN groups(P>0.05),but the blastocyst formation status of Day 5 was better than that of Day 6(P<0.05).(2)Blastocyst formation status of Day 2 subgroup B1(4-6 cells) was the best in 1 PN and 2 PN subgroup.(3)The blastocyst formation rate of Day 3 subgroup B2 and C2 in 0 PN group was significantly higher than that of subgroup A2(P<0.05),and the order of available blastocyst rate was as follows: subgroup C2>B2>A2(P<0.05). The order of blastocyst formation rate in Day 3 subgroup of 1 PN group was as follows: subgroup B2>C2>A2(P<0.05). The order of available blastocyst rate in the Day3 subgroup of 2 PN group was as follows: subgroup C2>B2>A2(P<0.05).(4)The blastocyst formation status in the subgroup A1(≤3 cells) of Day 2 group was the best in the 2 PN group(P<0.05). The blastocyst formation status of subgroup C1 was the best in 0 PN group(P<0.05).(5)The blastocyst formation status of Day 3 subgroup A2 was the best in 2 PN group(P<0.05).Conclusions:0 PN and 1 PN embryos with good morphology have good blastocyst development potential. The good-quality blastocysts formed by them may have certain utilization value.