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目的探讨卵裂期活检与囊胚期活检对胚胎发育的影响及在诊断结果上的差异。方法选择2013年3月至2016年10月在我中心对双方地中海贫血基因携带进行PGD治疗的夫妇,以63例共68个活检周期纳入研究,以同期的ICSI后行囊胚培养周期为对照组(共100个周期),实验组分卵裂期活检组(共40个)和囊胚期活检组(共28个周期),比较实验组与对照组的囊胚形成率、优质囊胚率的差异。同时比较卵裂期与囊胚期活检物在诊断结果上的差异。结果卵裂期活检组与对照组囊胚培养的囊胚形成率(57.86%VS 52.45%),无统计学差异(P>0.05),但优质囊胚率明显低于对照组(16.23%VS30.73%,P<0.05),而囊胚期组与对照组的优质囊胚率无统计学差异(P>0.05)。检测结果比较,未检出率卵裂期活检组高于囊胚期组(17.59%VS 7.05%),两组有统计学差异(P<0.05),两组的正常率及携带率均有统计学差异(P<0.05)。结论卵裂期活检将影响形成的囊胚质量从而影响胚胎发育潜能,诊断结果的准确性较差,囊胚期活检可以提高诊断结果的准确性,同时保护胚胎发育潜能,是地中海贫血PGD的最佳活检时机。
Objective To investigate the effects of cleavage biopsy and blastocyst biopsy on embryonic development and their differences in diagnosis. METHODS: From March 2013 to October 2016, we conducted a pilot study on 63 PGD-treated couples with thalassemia gene carriers in our center from June 2013 to October 2016. Sixty-six biopsies were enrolled in this study. A total of 100 cycles), the experimental component cleavage biopsy group (a total of 40) and the blastocyst biopsy group (a total of 28 cycles), the experimental group and the control group blastocyst formation rate, high-quality blastocyst rate differences . At the same time compare cleavage stage and blastocyst biopsy specimens in the diagnosis of differences. Results The blastocyst formation rate in blastocyst biopsy group and control group was 57.86% vs 52.45%, but there was no significant difference (P> 0.05). However, the blastocyst rate was significantly lower than that in control group (16.23% VS30). 73%, P <0.05), while there was no significant difference in blastocyst rate between blastocyst stage and control group (P> 0.05). Compared with the blastocyst stage (17.59% VS 7.05%), the undetected rate of cleavage stage biopsy group was statistically significant (P <0.05), and the normal rate and carrier rate of both groups were statistically Learning difference (P <0.05). Conclusions The cleavage stage biopsy will affect the quality of the formed blastocysts and thus affect the embryo development potential. The accuracy of the diagnostic results is poor. The blastocyst biopsy can improve the diagnostic accuracy and protect the embryonic development potential. Good timing of biopsy.