体外受精治疗后人类胚胎透明带厚度对临床妊娠结局的影响。
Influence of zona pellucida thickness of human embryos on clinical pregnancy outcome following in vitro fertilization treatment.
作者信息
Gabrielsen A, Bhatnager P R, Petersen K, Lindenberg S
机构信息
Ciconia Fertility Clinic, Arhus, Denmark.
出版信息
J Assist Reprod Genet. 2000 Jul;17(6):323-8. doi: 10.1023/a:1009453011321.
PURPOSE
To evaluate the correlation between the degree of zona pellucida thickness variation (ZPTV) of transferred embryos with identical morphologies and subsequent clinical pregnancy rates during 141 intracytoplasmic sperm injection (ICSI) treatment cycles.
METHODS
A total of 141 women participating in the study group comprising mostly male factor infertilities and some repeat in vitro fertilization (IVF) failures were transferred, 2 days after ovum pickup, with two to three embryos with identical grades created by fertilization with ICSI. All selected embryos were subjected to zona pellucida thickness measurements immediately prior to transfer using a computerized embryo measurement program from videocinematography recordings.
RESULTS
A total of 326 identical-grade transferred pre-embryos resulted in 70 clinical pregnancies with live-born implantation rate of 27.6%. A highly significant correlation was observed between ZPTV of transferred embryos and the IVF outcome with 77.1% and 83.64% of the clinical pregnancies resulting from transferred embryos with ZPTV values greater than 20 and 25, respectively. The mean ZPTV values for 70 conceptual cycles and 62 nonconceptual cycles were 28 +/- 6.43 and 17.85 +/- 8.11, respectively. No significant correlation between ZP thickness and number of blastomeres in the transferred embryos was evident, though embryos with better scores had significantly thinner zonae and higher ZPTV values. Though average zona thickness of embryos declined with age, the mean ZPTV value for women less than 30 years old was significantly higher (25.84 +/- 8.57) as compared with those from women older than 35 years (20.72 +/- 8.45).
CONCLUSIONS
The degree of ZPTV of the transferred embryos exhibits a strong correlation with clinical pregnancy outcome following IVF treatment. This potentially reliable indicator of IVF success rate could be used as a criteria for embryo selection during clinical transfers.
目的
评估在141个卵胞浆内单精子注射（ICSI）治疗周期中，形态相同的移植胚胎的透明带厚度变化程度（ZPTV）与随后临床妊娠率之间的相关性。
方法
研究组共有141名女性，主要为男性因素不育症患者以及部分体外受精（IVF）反复失败的患者，在取卵后2天移植了两到三个经ICSI受精产生的等级相同的胚胎。所有选定的胚胎在移植前立即使用来自视频电影记录的计算机化胚胎测量程序进行透明带厚度测量。
结果
总共326个等级相同的移植前胚胎导致70例临床妊娠，活产植入率为27.6%。观察到移植胚胎的ZPTV与IVF结果之间存在高度显著的相关性，ZPTV值大于20和25的移植胚胎分别导致77.1%和83.64%的临床妊娠。70个妊娠周期和62个未妊娠周期的平均ZPTV值分别为28±6.43和17.85±8.11。尽管评分较高的胚胎透明带明显更薄且ZPTV值更高，但移植胚胎的透明带厚度与卵裂球数量之间没有明显的相关性。虽然胚胎的平均透明带厚度随年龄下降，但小于30岁女性的平均ZPTV值（25.84±8.57）显著高于35岁以上女性（20.72±8.45）。
结论
移植胚胎的ZPTV程度与IVF治疗后的临床妊娠结局密切相关。这种IVF成功率的潜在可靠指标可作为临床移植时胚胎选择的标准。
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