使用酸性台氏液或激光进行透明带打孔后，人类胚胎活检结果与植入前基因诊断结局的比较。

Comparison of the results of human embryo biopsy and outcome of PGD after zona drilling using acid Tyrode medium or a laser.

作者信息

Joris H, De Vos A, Janssens R, Devroey P, Liebaers I, Van Steirteghem A

机构信息

Centre for Reproductive Medicine, Dutch-speaking Brussels Free University, Laarbeeklaan 101, 1090 Brussels, Belgium.

出版信息

Hum Reprod. 2003 Sep;18(9):1896-902. doi: 10.1093/humrep/deg355.

DOI:10.1093/humrep/deg355

PMID:12923146

Abstract

BACKGROUND

Zona pellucida opening for blastomere removal can be done by mechanical or chemical means, or by laser. So far, only limited data on the use of laser systems for zona drilling in cases of PGD are available.

METHODS

Results of embryo biopsy and outcome of PGD in two periods were compared. In the first period, acid Tyrode medium was used for zona drilling. In the second period, zona drilling was performed by a 1.48 micro m infrared laser.

RESULTS

In the first period, 59 cycles resulted in 53 biopsy procedures with 356 biopsied embryos. In the second period, these numbers were 69 cycles, 69 biopsy procedures and 402 biopsied embryos. Fewer blastomeres were intact (95.2%) after zona drilling with acid Tyrode than after laser zona drilling (98.3%, P = 0.02). Rates of positive HCG (37.5% versus 35.5%), ongoing pregnancy rates (31.3% versus 25.0%) and ongoing implantation rates (18.9% versus 14.9%) did not differ.

CONCLUSIONS

The use of a laser for zona drilling in cases of PGD is an easier procedure and results in more intact blastomeres. Since similar pregnancy rates are obtained, it is advantageous to use a laser for zona drilling. Further follow-up is necessary to prove the safety of this procedure.

摘要

背景

去除卵裂球时的透明带开口可通过机械、化学方法或激光来完成。到目前为止，关于在植入前基因诊断（PGD）病例中使用激光系统进行透明带钻孔的可用数据有限。

方法

比较了两个时期胚胎活检的结果和PGD的结局。在第一个时期，使用酸性台氏液进行透明带钻孔。在第二个时期，使用1.48微米红外激光进行透明带钻孔。

结果

在第一个时期，59个周期中有53次活检操作，共活检了356个胚胎。在第二个时期，这些数字分别为69个周期、69次活检操作和402个活检胚胎。与激光透明带钻孔后（98.3%）相比，用酸性台氏液进行透明带钻孔后完整的卵裂球更少（95.2%，P = 0.02）。血β-人绒毛膜促性腺激素（HCG）阳性率（37.5%对35.5%）、持续妊娠率（31.3%对25.0%）和持续着床率（18.9%对14.9%）没有差异。