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体外受精-胚胎移植(IVF-ET)治疗周期中胚胎学实验室环境污染所致微生物污染的临床结局分析。

Analysis of the clinical outcomes of microbial contamination caused by environmental contamination of the embryology laboratory during IVF-ET treatment cycles.

作者信息

Zheng Tingting, Li Qinhua, Chen Ningjing, Du Peiyao, Ye Hong

机构信息

Department of Obstetrics and Gynecology, The First College of Clinical Medical Science, Yichang Central People's Hospital, Three Gorges University, 183 Yiling St, Yichang, Hubei, 443003, China.

出版信息

BMC Pregnancy Childbirth. 2023 Mar 18;23(1):190. doi: 10.1186/s12884-023-05516-6.

Abstract

BACKGROUND

Bacterial contamination may cause loss of or damage to cultured oocytes or embryos, resulting in the lack of transplantable embryos during IVF embryo culture. However, there are few reports about IVF embryo contamination caused by embryology laboratories. In this work, we evaluated clinical pregnancy outcomes and the risk of maternal and infant complications after embryo contamination caused by environmental pollution during IVF.

METHODS

The authors retrospectively analyzed 2490 IVF-ET ovulation induction therapy cycles in the Reproductive Center of Yichang Central People's Hospital from January 2015 to May 2022. According to the presence or absence of embryo culture medium contamination, the two groups were divided into an embryo contamination cycle and a nonembryo contamination cycle. The primary outcome parameters were the characteristics and progress of embryo culture medium contamination. Embryo laboratory outcomes, pregnancy outcomes, and maternal and infant complications were secondary outcome parameters.

RESULTS

One case of embryo contamination originated from semen contamination. The remaining 15 cases involved environmental contamination outbreaks in embryo culture chambers, caused by Staphylococcus pasteuri. Compared with conventional uncontaminated IVF cycles, the 15 cases of contaminated embryo cycles showed no significant difference in embryo laboratory outcomes, pregnancy outcomes, or maternal and infant complications except for a slightly higher rate of fetal growth retardation. Ultimately, 11 live-born infants were successfully delivered, of which 2 were premature. The remaining 4 patients did not become pregnant after 1-2 transfers due to a lack of transferable embryos.

CONCLUSION

When the embryo culture medium is contaminated due to the environmental contamination of the IVF culture room, it is feasible to perform daily rapid rinsing of the culture medium and avoid blastocyst culture as remedial treatment. However, the long-term impact on offspring needs further prospective research.

摘要

背景

细菌污染可能导致培养的卵母细胞或胚胎丢失或受损,导致体外受精(IVF)胚胎培养过程中缺乏可移植胚胎。然而,关于胚胎学实验室导致的IVF胚胎污染的报道很少。在本研究中,我们评估了IVF期间环境污染导致胚胎污染后的临床妊娠结局以及母婴并发症风险。

方法

作者回顾性分析了2015年1月至2022年5月宜昌市中心人民医院生殖中心2490个IVF-ET排卵诱导治疗周期。根据胚胎培养基是否受到污染,将两组分为胚胎污染周期和非胚胎污染周期。主要结局参数为胚胎培养基污染的特征和进展情况。胚胎实验室结局、妊娠结局以及母婴并发症为次要结局参数。

结果

1例胚胎污染源于精液污染。其余15例涉及胚胎培养室的环境污染暴发,由巴氏葡萄球菌引起。与传统未受污染的IVF周期相比,15例污染胚胎周期在胚胎实验室结局、妊娠结局或母婴并发症方面无显著差异,只是胎儿生长受限率略高。最终成功分娩11名活产婴儿,其中2例早产。其余4例患者因缺乏可移植胚胎,在1-2次移植后未怀孕。

结论

当IVF培养室的环境污染导致胚胎培养基污染时,对培养基进行每日快速冲洗并避免囊胚培养作为补救措施是可行的。然而,对后代的长期影响需要进一步的前瞻性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4107/10024385/8e02c8dc00e8/12884_2023_5516_Fig1_HTML.jpg

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