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目的:初步探寻体外受精-胚胎移植(IVF-ET)周期中高发育潜能的1原核(PN)及0PN(2Pb)胚胎的方法。方法:观察787个IVF周期患者的PN及卵裂情况,培养至第6日,观察其囊胚形成情况。取囊胚滋养层细胞活检,采用胚胎植入前遗传学筛查(PGS)技术检测0PN(2Pb)、1PN及2PN囊胚的染色体组成。结果:787个IVF周期共获卵8 352枚,2PN、0PN(2Pb)、1PN胚胎的形成率分别为64.35%、4.93%、3.65%,囊胚形成率分别为45.71%、30.03%、18.18%。PGS结果显示,1PN及0PN(2Pb)囊胚染色体正常的比例明显低于2PN囊胚,差异有统计学意义(P<0.05)。0PN(2Pb)囊胚的染色体正常比例较1PN囊胚的略高,差异无统计学意义(P>0.05)。此外,发育至第6日的0PN(2Pb)囊胚及1PN囊胚较第5日胚胎的正常染色体比例高。结论:对于本周期无可利用胚胎的患者,建议移植1PN及0PN(2Pb)来源的第6日评分较好的囊胚。
OBJECTIVE: To explore a method for early development of high prokaryotic (PN) and 0PN (2Pb) embryos in IVF-ET cycles. Methods: PN and cleavage in 787 IVF patients were observed. The cells were cultured until the 6th day and their blastocyst formation was observed. The blastocyst trophoblast cell biopsies were used to detect the chromosomal composition of 0PN (2Pb), 1PN and 2PN blastocysts by preimplantation genetic screening (PGS) technique. Results: A total of 8 352 eggs were obtained in 787 IVF cycles. The formation rates of 2PN, 0PN (2Pb) and 1PN embryos were 64.35%, 4.93% and 3.65%, respectively. The blastocyst formation rates were 45.71%, 30.03% and 18.18% . The results of PGS showed that the normal proportion of 1PN and 0PN (2Pb) blastocysts was significantly lower than 2PN blastocysts, the difference was statistically significant (P <0.05). The chromosome normal ratio of 0PN (2Pb) blastocysts was slightly higher than 1PN blastocysts, with no significant difference (P> 0.05). In addition, 0PN (2Pb) blastocysts and 1PN blastocysts developed to day 6 had higher proportion of normal chromosomes than day 5 embryos. Conclusion: For patients with no available embryos in this cycle, we recommend the transplantation of 1 day PN and 0PN (2Pb) derived day 6 blastocysts.