Tucker M J, Luecke N M, Wiker S R, Wright G
Reproductive Biology Associates, Atlanta, Georgia 30342.
J Assist Reprod Genet. 1993 Apr;10(3):187-91. doi: 10.1007/BF01239219.
Two hundred eighteen consenting patients entered a randomized study of the application of chemical zona pellucida thinning on their day 3 embryos, prior to uterine transfer. Of those control patients (n = 108), whose embryos remained unmanipulated, 40 (37.0%) have ongoing/delivered pregnancies, while in the experimental group (n = 110), whose embryos had their zonae pellucidae chemically thinned, there are 49 patients (44.6%) who have ongoing/delivered pregnancies. Although this difference is not significant, clearly the application of this micromanipulative intervention has not been detrimental, and this bodes well for routine application of embryonic micromanipulation procedures in general. Certain patient subgroups were studied including older women, those with elevated basal follicle stimulating hormone levels, patients with embryos of differing zona thickness, and patients with embryos of differing uniformity of zona thickness. No significant influence of chemical removal of the outside of the zona on the implantation rate of embryos in any of these subgroups was observed other than a marginally significant (P = 0.095) improvement of implantation of embryos with less than 4.0 microns variation in zona thickness when chemical zona thinning was applied. Failure of chemical zona thinning to enhance human embryo implantation significantly, compared to assisted hatching by complete zona drilling, strongly suggests that the bilayered human zona pellucida needs to be fully breached, unlike that of the mouse.
218名同意参与研究的患者在子宫移植前,对其第3天的胚胎进行了化学性透明带变薄处理的随机研究。在那些未对胚胎进行处理的对照组患者(n = 108)中,有40名(37.0%)有持续妊娠/已分娩,而在胚胎透明带经化学性变薄处理的实验组(n = 110)中,有49名患者(44.6%)有持续妊娠/已分娩。虽然这种差异不显著,但显然这种显微操作干预的应用并无害处,总体而言,这对于胚胎显微操作程序的常规应用是个好兆头。对某些患者亚组进行了研究,包括年龄较大的女性、基础卵泡刺激素水平升高的患者、透明带厚度不同的胚胎的患者以及透明带厚度均匀性不同的胚胎的患者。除了在应用化学性透明带变薄时,透明带厚度变化小于4.0微米的胚胎着床有轻微显著(P = 0.095)改善外,未观察到化学性去除透明带外层对这些亚组中任何一组胚胎着床率有显著影响。与通过完全钻透透明带进行辅助孵化相比,化学性透明带变薄未能显著提高人类胚胎着床,这强烈表明与小鼠不同,人类双层透明带需要被完全穿透。