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[常规体外受精后改良原核期评分系统的临床应用]

[Clinical application of a modified pronuclear stage scoring system following conventional in-vitro fertilization].

作者信息

Xu Yan-wen, Zhuang Guang-lun, Fang Cong, Shu Yi-min, Zhang Min-fang, Peng Wen-lin

机构信息

Reproductive Medical Research Center, the First Affiliated Hospital of Sun Yan-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2003 Jun;38(6):343-5.

Abstract

OBJECTIVE

To assess the clinical value of pronuclear stage scoring system in human conventional in vitro fertilization-embryo transfer (IVF-ET) program.

METHODS

A modified pronuclear scoring system was used to score zygotes 16 - 18 hours after insemination during conventional IVF.

RESULTS

A total of 178 IVF cycles were recruited in this study. Cycles with mean pronuclear score (sum of pronuclear scores of all transferred embryos divided by total number of transferred embryos) > or = 13 had significant high pregnancy and implantation rate, as compared to those with less than 13 (49.1% and 26.5% Vs 29.4% and 15.0% respectively). Although the pregnancy, implantation rate and multiple pregnancy rate tend to increase with the increasing number of zygotes with full pronuclear score (= 15) among transferred embryos, no significant difference could be found (P > 0.05). When all embryos were analyzed, 77.2% zygotes with pronuclear score > or = 11 could be transferred or cryopreserved, while those with pronuclear score less than 11 decreased to 46.1%.

CONCLUSIONS

Pronuclear stage scoring system provides additional parameter for embryo selection. However, pronuclear morphology could only partly represent embryonic viability. Combination with the scoring of both pronuclear stage and cleavage stage embryos for selecting transferred embryos is indispensable.

摘要

目的

评估原核期评分系统在人类常规体外受精 - 胚胎移植(IVF - ET)程序中的临床价值。

方法

采用改良的原核评分系统,在常规IVF受精后16 - 18小时对受精卵进行评分。

结果

本研究共纳入178个IVF周期。平均原核评分(所有移植胚胎的原核评分总和除以移植胚胎总数)≥13的周期,其妊娠率和着床率显著高于评分低于13的周期(分别为49.1%和26.5%,对比29.4%和15.0%)。尽管随着移植胚胎中完全原核评分(= 15)的受精卵数量增加,妊娠率、着床率和多胎妊娠率有上升趋势,但差异无统计学意义(P > 0.05)。当分析所有胚胎时,原核评分≥11的受精卵中有77.2%可用于移植或冷冻保存,而原核评分低于11的则降至46.1%。

结论

原核期评分系统为胚胎选择提供了额外参数。然而,原核形态只能部分代表胚胎活力。将原核期和卵裂期胚胎评分相结合以选择移植胚胎是必不可少的。

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