南方医科大学学报

南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (12): 1760-.

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使用time-lapse筛选早期IVF/ICSI 胚胎及其临床结局

陈明颢，黄军，钟影，全松   

  • 出版日期:2015-12-20 发布日期:2015-12-20

Embryo selection in IVF/ICSI cycles using time-lapse microscopy and the clinical
outcomes

  • Online:2015-12-20 Published:2015-12-20

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摘要： 目的通过比较使用time-lapse(延迟摄像)和传统形态学方法筛选IVF/ICSI胚胎的临床结局，评价time-lapse用于早期胚胎
观察和筛选的价值。方法回顾性分析139个IVF/ICSI 周期的资料，根据胚胎的筛选方法，分为time-lapse monitoring 组（TLM
组）（n=68）和对照组（n=71），比较两组间的βHCG阳性率、临床妊娠率和胚胎着床率，并根据女方年龄、受精方式进行亚组分
析。结果TLM组的βHCG阳性率、临床妊娠率、胚胎着床率分别为：66.2%、61.8%、47.1%；对照组的βHCG阳性率、临床妊娠
率、胚胎着床率分别为：47.9%、43.7%、30.3%；TLM组的βHCG阳性率、临床妊娠率、胚胎着床率均高于对照组，且差异均有统计
学意义（P<0.05）。亚组分析显示：相较于年龄≤30岁的患者，年龄31~35岁的患者利用time-lapse更能明显改善临床结局；利用
time-lapse能明显提高IVF周期的βHCG阳性率、临床妊娠率、胚胎着床率，但对于ICSI和TESA周期，效果则不理想。结论使
用time-lapse动态监测胚胎并根据胚胎的形态动力学参数对胚胎进行评价和筛选，与传统方法相比，能获得更好的临床结局；年
龄较大的（>30岁）或者是进行IVF周期的患者更能从中获益。

Abstract: Objective To compare the clinical outcomes of embryos selected using time-lapse microscopy and traditional
morphological method in IVF/ICSI cycles and evaluate the clinical value of time-lapse microscopy in early embryo monitoring
and selection. Methods We retrospectively analyzed the clinical data of 139 IVF/ICSI cycles with embryo selection based on
time-lapse monitoring (TLM group, n=68) and traditional morphological method (control group, n=71). The βHCG-positive
rate, clinical pregnancy rate and embryo implantation rate were compared between the 2 groups. Subgroup analysis was
performed in view of female patients’age and the fertilization type. Results The βHCG-positive rate, clinical pregnancy rate
and implantation rate were 66.2%, 61.8% and 47.1% in TLM group, significantly higher than those in the control group (47.9%,
43.7% and 30.3%, respectively; P<0.05). Compared with patients below 30 years of age, patients aged between 31 and 35 years
benefited more from time-lapse monitoring with improved clinical outcomes. time-lapse monitoring significantly increased the
βHCG-positive rate, clinical pregnancy rate and implantation rate for patients undergoing IVF cycles, but not for those
undergoing ICSI or TESA cycles. Conclusion Compared with those selected using traditional morphological method, the
embryos selected with time-lapse microscopy have better clinical outcomes, especially in older patients (31-35 years of age)
and in IVF cycles.