Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing210008, China.
Center for Molecular Reproductive Medicine, Nanjing University, Nanjing210008, China.
Zygote. 2024 Feb;32(1):7-13. doi: 10.1017/S0967199423000515. Epub 2023 Nov 29.
Abnormalities in the zona pellucida (ZP) adversely affect oocyte maturation, embryo development and pregnancy outcomes. However, the assessment of severity is challenging. To evaluate the effects of different degrees of ZP abnormalities on embryo development and clinical outcomes, in total, 590 retrieval cycles were scored and divided into four categories (control, mild, moderate and severe) based on three parameters: perivitelline space, percentage of immature oocytes and percentage of oocytes with abnormal morphology. As the severity of abnormal ZP increased, both the number of retrieved oocytes and mature oocytes decreased. The fertilization rate did not differ significantly among groups. The rates of embryo cleavage and day-3 high-quality embryos in the mild group and the moderate group did not vary significantly between the two groups but were significantly higher than those in the severe group. The blastulation rates of the abnormal ZP groups were similar; however, they were lower than those of the control group. Moreover, the cycle cancellation rate of the severe abnormal ZP group was as high as 66.20%, which was significantly higher than that of the other three groups. Although the rates of cumulative clinical pregnancy and live births were lower than those in the control group, they were comparable among the abnormal ZP groups. There were no differences in the neonatal outcomes of the different groups. Together, ZP abnormalities show various degrees of severity, and in all patients regardless of the degree of ZP abnormalities who achieve available embryos, there will be an opportunity to eventually give birth.
透明带异常（ZP）会对卵母细胞成熟、胚胎发育和妊娠结局产生不利影响。然而，评估其严重程度具有挑战性。为了评估不同程度的 ZP 异常对胚胎发育和临床结局的影响，共对 590 个取卵周期进行评分，并根据三个参数将其分为四个类别（对照组、轻度、中度和重度）：卵周间隙、未成熟卵母细胞百分比和形态异常卵母细胞百分比。随着 ZP 异常的严重程度增加，可获取的卵母细胞和成熟卵母细胞数量均减少。各组间受精率无显著差异。轻度组和中度组的胚胎卵裂率和第 3 天优质胚胎率在两组间无显著差异，但显著高于重度组。异常 ZP 组的囊胚形成率相似；然而，其低于对照组。此外，重度异常 ZP 组的周期取消率高达 66.20%，显著高于其他三组。虽然累积临床妊娠率和活产率低于对照组，但异常 ZP 组之间相当。各组新生儿结局无差异。总之，ZP 异常表现出不同程度的严重程度，所有患者无论 ZP 异常程度如何，只要获得可利用的胚胎，就有最终分娩的机会。
