目的 探讨体外受精治疗中第3天(D3)不同质量卵裂期胚胎培养至囊胚的发育潜能,为囊胚培养提供实验室依据。方法 对2015年4月—2019年4月D3移植或冷冻后剩余行囊胚培养的5 510枚胚胎进行了回顾性分析。按D3胚胎质量、卵裂球数目、均一性及碎片率分组,比较囊胚形成率,优质囊胚形成率及可利用囊胚形成率,并分析各因素与可利用囊胚形成的相关性。结果 D3优质胚胎的囊胚形成率,优质囊胚形成率及可利用囊胚形成率与非优质胚胎组相比有统计学差异(P＜0.05);4-6细胞组及＜4细胞组与7-9细胞组相比有统计学差异(P＜0.05),但融合期胚胎(CP)组及＞ 9细胞组与7-9细胞组相比差异无统计学意义;卵裂球大小差异(+)组和(++/+++)组与卵裂球大小均匀(-)相比有统计学差异(P＜0.05); 10%～25%组及碎片＞25%组与碎片≤10%组相比有统计学差异(P＜0.05)。 Logistic分析结果表明,D3胚胎质量、卵裂球数目、均一性及胚胎碎片率与可利用囊胚形成显著相关(P＜0.05)。 结论 D3胚胎质量、卵裂球数目、均一性及胚胎碎片均会影响到囊胚的形成及质量,其中胚胎质量和卵裂球数目对可利用囊胚形成的影响较大。

Objective To explore the developmental potential of day 3(D3) different quality embryos cultured to blastocyst in vitro fertilization treatment, and to provide laboratory basis for blastocyst culture. Methods A total of 5 510 embryos with blastocyst culture remained after D3 transplantation or freezing from April 2015 to April 2019 were analyzed retrospectively. They were divided into groups according to embryo quality, blastomere number, blastomere homogeneity and fragment rate in D3. And the blastocyst formation rate, high quality blastocyst formation rate and available blastocyst formation rate were compared between the groups.The correlation within each factor and available blastocyst formation was analyzed. Results The blastocyst formation rate, high quality blastocyst formation rate and available blastocyst formation rate of D3 high quality embryo group were higher than those of non-high quality embryo group (P<0.05); compared with 7- 9 cell group, 4- 6 cell group and<4 cell group were lower (P<0.05), but there was no significant difference in CP group or >9 cell group. Compared with the normal size of the blastomere (-), the difference in the size of the blastomere (+) group and the (++/+++) group decreased (P<0.05); compared with the fragment ≤ 10%, the difference in the size of the blastomere between the 10%~25% group and the fragment>25% group decreased (P<0.05). The results of logistic analysis suggested that the embryo quality, blastomere number, homogeneity and fragment rate of D3 were correlated with available blastocyst formation (P<0.05). Conclusion D3 embryo quality, blastomere number, homogeneity and embryo fragment may affect the formation and quality of blastocyst, especially the embryo quality and blastomere number.