Reproductive Medical Center, General Hospital of Lanzhou Military Region, Lanzhou, China.
Key Laboratory of Reproduction and Genetics, Ningxia Medical University, Yinchuan, China.
J Assist Reprod Genet. 2018 Feb;35(2):321-329. doi: 10.1007/s10815-017-1065-5. Epub 2017 Nov 9.
The purpose of this study is to investigate the application value of the extended embryo culture for 7-8 h in day 3 morning during IVF-ET process.
Embryos were retrospectively assessed during 08:00-09:00 on the morning of day 3 in the control group, and were assessed once again at 16:00 in the afternoon in the extended culture (EC) group. The embryos with good developmental potential were preferentially selected to transfer. The cumulative pregnancy outcomes were analyzed in one oocyte retrieval cycle.
Similar proportions were found in the rates of cumulative clinical pregnancy, cumulative live birth, and the perinatal/neonatal outcomes per oocyte retrieval cycle (P > 0.05). But higher total clinical pregnancy rate, higher total implantation rate, and lower total abortion rate were obtained in the EC group (P < 0.05). After EC, 53.58% of the embryos were able to continue to develop. The transferred embryos were mainly composed of ≥ 8-cell embryos (75.90%) in the EC group and ≤ 8-cell embryos (82.92%) in the control group. Interestingly, the implantation rates were increasingly improved with the increasing blastomere number up to 56.31% at the morula stage in the EC group, while they were limited to 32.33% at 8-cell stage in the control group.
The extended culture of day 3 embryos for 7-8 h not only reduced the risk of IVF-ET treatment compared to blastocyst culture through another 2-3 days, but also improved the clinical outcomes and the efficiency of every transferred cycle and every transferred embryo.
本研究旨在探讨在体外受精-胚胎移植（IVF-ET）过程中，将第 3 天的胚胎延长培养 7-8 小时的应用价值。
对照组在第 3 天的上午 08:00-09:00 对胚胎进行回顾性评估，而在延长培养（EC）组则在下午 16:00 再次评估。优先选择具有良好发育潜力的胚胎进行移植。分析一个取卵周期内的累积妊娠结局。
在每个取卵周期的累积临床妊娠率、累积活产率和围产儿/新生儿结局率方面，两组的比例相似（P>0.05）。但 EC 组的总临床妊娠率、总着床率更高，总流产率更低（P<0.05）。EC 后，53.58%的胚胎能够继续发育。EC 组中转移的胚胎主要由≥8 细胞胚胎（75.90%）组成，而对照组中则主要由≤8 细胞胚胎（82.92%）组成。有趣的是，在 EC 组中，胚胎的着床率随着卵裂球数的增加而逐渐提高，在桑椹胚阶段达到 56.31%，而在对照组中，卵裂球数达到 8 细胞阶段时则达到 32.33%。
与囊胚培养再延长 2-3 天相比，第 3 天的胚胎延长培养 7-8 小时不仅降低了 IVF-ET 治疗的风险，还改善了临床结局和每个移植周期和每个移植胚胎的效率。
