胚胎密度对卵裂期优质胚胎率的影响

doi:10.16098/j.issn.0529-1356.2021.01.022

摘要/Abstract

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。

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

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.

Key words: Embryo density, Embryo quality, Individual culture, Group culture, Embryo culture, Female

中图分类号:

Q813.7

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.

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.

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