Division of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, 0027 Oslo, Norway.
Reprod Biomed Online. 2010 Jul;21(1):118-25. doi: 10.1016/j.rbmo.2010.03.018. Epub 2010 Mar 28.
Routine morphological scoring systems in assisted reproduction treatment are based on parameters that presumably correlate with the biological quality of gametes and embryos, including chromosome abnormalities. Maternal age is a key factor predicting pregnancy and live birth, and it is therefore of considerable interest to identify age-related indicators of oocyte and embryo quality in assisted reproduction treatment. The purpose of this study was to examine whether routine morphological scoring systems reflect age-related impact on oocyte and embryo quality among 4587 couples undergoing their first assisted reproduction treatment. This study assessed over 43,000 oocytes, 25,000 embryos and 7900 transferred embryos and analysed the associations among the following parameters: number of oocytes retrieved, oocyte quality, including maturity, fertilization rates, embryo quality, based on morphological features, and treatment outcome. Advanced chronological age was found to be associated with fewer oocytes retrieved, fewer embryos available for cryopreservation, as well as lower pregnancy, implantation, live birth rates and a higher miscarriage rate. No age-related correlation was found between fertilization rates, oocyte or embryo quality. Routinely-used morphological scoring systems, such as assessment of blastomere count, shape and fragmentation, fail to reflect age-related impact on oocyte and embryo quality.
常规形态学评分系统在辅助生殖治疗中基于与配子和胚胎的生物学质量相关的参数，包括染色体异常。母亲年龄是预测妊娠和活产的关键因素，因此确定辅助生殖治疗中与年龄相关的卵母细胞和胚胎质量指标具有重要意义。本研究旨在检查常规形态学评分系统是否反映了 4587 对接受首次辅助生殖治疗的夫妇中年龄对卵母细胞和胚胎质量的影响。本研究评估了超过 43000 个卵母细胞、25000 个胚胎和 7900 个移植胚胎，并分析了以下参数之间的关联：获得的卵母细胞数量、卵母细胞质量，包括成熟度、受精率、胚胎质量，基于形态特征，以及治疗结果。高龄与获得的卵母细胞数量减少、可用于冷冻保存的胚胎数量减少、妊娠率、着床率、活产率降低和流产率升高有关。受精率、卵母细胞或胚胎质量与年龄无相关性。常规使用的形态学评分系统，如卵裂球计数、形状和碎片的评估，未能反映年龄对卵母细胞和胚胎质量的影响。
