第3天和第5天胚胎形态的组合能否用于预测体外受精周期中的妊娠情况？

Can combination of Day 3 and Day 5 embryo morphology be useful to predict pregnancy in in-vitro fertilization cycles?

作者信息

Demir A, Köse M, Bozdag G, Sokmensuer L Karakoc, Sever A, Gunalp S

机构信息

Department of Obstetrics and Gynecology, Elaziğ Training and Research Hospital, Turkey.

出版信息

Clin Exp Obstet Gynecol. 2014;41(6):685-8.

PMID:25551963

Abstract

OBJECTIVE

To determine whether embryos having all top qualified both on Day 3 and Day 5 have higher pregnancy rates than the oth- ers.

MATERIALS AND METHODS

The study included 143 consecutive cycles were recruited in which Day 5 embryo transfer was available. Cleavage stage embryos were graded according to 1 to 4 scoring system, based on fragmentation, cell symmetry, and blastomere num- ber. Among cleavage stage embryos, Grade 1 and Grade 2a/2b were further stratified as 'top quality' embryos to be transferred, others were defined as control group. Blastocyst stage embryos were graded from 1 to 6 according to intracellular mass (ICM) and trophec- toderm (TE). Day 5 fresh embryo transfer was performed in all cases using soft catheter. Positive pregnancy test was accepted when serum beta-human chorionic gonadotrophin (1-hCG) exceeded 20 mIU/ml.

RESULTS

On the cleavage stage, top quality embryo was available in 47 of 143(32.9%) cases. Of the 47 embryos, the number of cases reaching any Grade 4, 3 quality, and early blastocyst on Day 5 were 22 (46.8%), 15 (31.9%), and 10 (21.3%). The respective figures on the control group (n = 96) were 33 (34.4%), 37 (38.5%), and 26 (27.1%) (p > 0.05). The pregnancy rates were also similar.

CONCLUSION

All top qualified embryos both on Day 3 and 5 did not reveal higher pregnancy rate than the others.

摘要

目的

确定在第3天和第5天都具备所有顶级质量标准的胚胎是否比其他胚胎有更高的妊娠率。

材料与方法

该研究纳入了143个连续的可进行第5天胚胎移植的周期。卵裂期胚胎根据碎片程度、细胞对称性和卵裂球数量，按照1至4分的评分系统进行分级。在卵裂期胚胎中，1级和2a/2b级被进一步分类为待移植的“顶级质量”胚胎，其他胚胎被定义为对照组。囊胚期胚胎根据内细胞团（ICM）和滋养外胚层（TE）从1至6级进行分级。所有病例均使用软导管进行第5天新鲜胚胎移植。当血清β-人绒毛膜促性腺激素（β-hCG）超过20 mIU/ml时，接受妊娠试验阳性结果。

结果

在卵裂期，143例（32.9%）中有47例获得顶级质量胚胎。在这47个胚胎中，第5天达到任何4级、3级质量和早期囊胚的病例数分别为22例（46.8%）、15例（31.9%）和10例（21.3%）。对照组（n = 96）的相应数字分别为33例（34.4%）、37例（38.5%）和26例（27.1%）（p>0.05）。妊娠率也相似。