Gardner D K
Colorado Center for Reproductive Medicine, Englewood 80110, USA.
Hum Reprod. 1998 Dec;13 Suppl 4:218-25. doi: 10.1093/humrep/13.suppl_4.218.
The culture and transfer of the blastocyst stage embryo has several advantages for assisted reproduction in the human. However, due to inadequacies of present culture conditions in human in-vitro fertilization (IVF), embryos are routinely transferred to the uterus on either day 2 or day 3 of development around the 4- to 8-cell stage, with resultant implantation rates of only 10-25%. In other mammalian species the transfer of cleavage stage embryos, which normally reside in the oviduct, results in a significantly lower implantation rate compared with the transfer of blastocysts. Extended culture of human embryos in vitro will help to identify those embryos with little, if any, developmental potential. It is therefore plausible that the blastocyst has an intrinsically higher viability than the cleavage stage embryo. It has now been shown in human IVF that sequential serum-free media can support > 50% blastocyst development, with an implantation rate per blastocysts of 50%, double that obtained for cleavage stage embryos. As the implantation rate of the blastocyst is higher than the cleavage stage embryo, fewer blastocysts are required for transfer. The development of completely defined embryo culture media may prove feasible by the replacement of protein with the glycosaminoglycan hyaluronate. Hyaluronate, which is protein-free, is more suitable than albumin in supporting implantation in the mouse, and can eliminate the biological variation inherent when using protein and the potential for contamination when using blood products such as albumin.
囊胚期胚胎的培养与移植对人类辅助生殖具有诸多优势。然而,由于目前人类体外受精(IVF)培养条件的不足,胚胎通常在发育的第2天或第3天,即4至8细胞阶段被常规移植到子宫,其着床率仅为10%至25%。在其他哺乳动物物种中,与囊胚移植相比,通常位于输卵管的卵裂期胚胎移植后的着床率显著降低。人类胚胎的体外延长培养将有助于识别那些发育潜力很小甚至没有发育潜力的胚胎。因此,囊胚的内在活力可能高于卵裂期胚胎,这似乎是合理的。目前在人类IVF中已表明,序贯无血清培养基可支持超过50%的囊胚发育,每个囊胚的着床率为50%,是卵裂期胚胎着床率的两倍。由于囊胚的着床率高于卵裂期胚胎,移植所需的囊胚数量较少。通过用糖胺聚糖透明质酸替代蛋白质,完全确定的胚胎培养基的开发可能被证明是可行的。透明质酸不含蛋白质,在支持小鼠着床方面比白蛋白更合适,并且可以消除使用蛋白质时固有的生物学变异以及使用白蛋白等血液制品时的污染可能性。