胚胎密度对卵裂期优质胚胎率的影响

石程 陈淑文 王平 梁蓉 段胜男 陈曦

解剖学报 ›› 2021, Vol. 52 ›› Issue (1) : 135-140.

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解剖学报 ›› 2021, Vol. 52 ›› Issue (1) : 135-140. DOI: 10.16098/j.issn.0529-1356.2021.01.022
组织学胚胎学发育生物学

胚胎密度对卵裂期优质胚胎率的影响

  • 石程 陈淑文 王平 梁蓉 段胜男 陈曦*
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Impact of embryo density on the proportion of good quality cleavage embryos

  •  SHI Cheng  CHEN Shu-wen  WANG Ping  LIANG Rong  DUAN Sheng-nan  CHEN Xi*
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文章历史 +

摘要

目的  通过调整协变量来探索培养的胚胎密度与第3天卵裂期胚胎发育结果之间的相关性。  方法  回顾性分析206对夫妇1196个胚胎体外受精-胚胎移植(IVF-ET)治疗的资料。培养条件为低氧,培养液每微滴体积为30 μl。以第3天卵裂期胚胎的优质胚胎率为终点指标对胚胎质量进行评价。选择女方年龄,男方年龄,窦卵泡数,抗苗勒管激素(AMH)水平,不孕症类型,控制性卵巢刺激(COS)方案,用药刺激时长,获卵数和授精方式为协变量。  结果  共有1196枚胚胎纳入分析,使用3种不同胚胎密度:30 μl/胚[1枚胚胎/(30 μl·滴)]、15 μl/胚[2枚胚胎/(30 μl·滴)]和10 μl/胚[3枚胚胎/(30 μl·滴)]进行培养,每组总胚胎数分别为434枚,646枚和116枚。10 μl/胚组第3天胚胎的优质胚胎率显著低于15 μl/胚和30 μl/胚组 (29.31% vs 40.25%,P<0.05;29.31% vs 42.17%,P<0.05),15 μl/胚和30 μl/胚组之间的优质胚胎率差异不显著(40.25% vs 42.17%,P>0.05)。在回归分析中,不调整任何协变量,10 μl/胚组第3天胚胎的优质胚胎率比30 μl/胚组下降43%(0.57,95%CI 0.32,1.03),差异无统计学意义(P>0.05)。调整了女性参与者AMH水平和授精方式后,10 μl/胚组第3天胚胎的优质胚胎率比30 μl/胚组显著降低51%(0.49,95% CI 0.27,0.90,P<0.05)。  结论  在30 μl微滴的低氧培养条件下,与单独培养相比,胚胎密度为10 μl/胚的集合培养不利于卵裂期胚胎发育,30 μl/胚为最适胚胎培养密度。

Abstract

Objective To investigate the real correlation between embryo density and developmental outcome of cleavage embryos on day 3 by adjusting covariates.   Methods  Data of 1196 embryos from 206 couples undergoing in vitro fertilization and embryo transfer(IVF-ET) treatment were retrospectively analyzed. Embryos were hypoxia-cultivated in a fixed 30 μl microdrop in culture dishes. Embryo quality on day 3 was evaluated and proportion of good quality cleavage embryos on day 3 was used as the endpoint. Maternal age, paternal age, antral follicles, level of anti-mullerian hormone (AMH), type of infertility, controlled ovarian stimulation(COS) protocol, length of stimulation, number of retrieved oocytes, and type of insemination were chosen as covariates.   Results  A total of 1196 embryos were included and analyzed. Three embryo densities were routinely used: 30 μl/embryo [1 embryo/(30 μl·drop)], 15 μl/embryo [2 embryos /(30 μl·drop)] and 10 μl/embryo [3 embryos/(30 μl·drop)]. The number of embryos assigned into these three groups were 434, 646 and 116 embryos separately. The average proportion of good quality embryos on day 3 in 10 μl/embryo group were lower than that in both 15 and 30 μl/embryo group (29.31% vs 40.25%,P<0.05;29.31% vs 42.17%,P<0.05), and it was comparable between groups of 15 and 30 μl/embryo (40.25% vs 42.17%,P>0.05). In the regression analysis, without adjusting any covariables, the good quality embryos rate on day 3 of the 10 μl/embryo group was 43% lower than that of the 30 μl/embryo group (0.57, 95% CI 0.32, 1.03), and there was no statistical difference (P>0.05). In the minimum-adjusted model 2 (adjusted the level of AMH and type of insemination), proportion of good quality embryos on day 3 in group of 10 μl/embryo significantly decreased by 51% (0.49, 95%CI 0.27,0.90, P<0.05) compared with that in group of 30 μl/embryo. 
  ConclusionIn a 30 μl microdrop, compared with individual cul turing, group culturing with the density of 10 μl/embryo did not benefit the development of the cleavage embryos and 30 μl/embryo was the optimal embryo density.

关键词

胚胎密度 / 胚胎质量 / 单胚培养 / 集合培养 / 胚胎培养 / 女性

Key words

Embryo density / Embryo quality / Individual culture / Group culture / Embryo culture / Female

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导出引用
石程 陈淑文 王平 梁蓉 段胜男 陈曦. 胚胎密度对卵裂期优质胚胎率的影响[J]. 解剖学报. 2021, 52(1): 135-140 https://doi.org/10.16098/j.issn.0529-1356.2021.01.022
SHI Cheng CHEN Shu-wen WANG Ping LIANG Rong DUAN Sheng-nan CHEN Xi. Impact of embryo density on the proportion of good quality cleavage embryos[J]. Acta Anatomica Sinica. 2021, 52(1): 135-140 https://doi.org/10.16098/j.issn.0529-1356.2021.01.022
中图分类号: Q813.7   

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中华医学会临床医学科研专项资金;首都临床特色应用研究与成果推广项目

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