囊胚期胚胎型態可預測其染色體正常與否
ICM(內細胞體)與染色體正常與否高度相關
異常ICM其囊胚染色體100%異常
Blastocyst Morphology Holds Clues Concerning The Chromosomal Status of The Embryo.
Abstract
BACKGROUND:
Embryo morphology has been proposed as an alternative marker of chro- mosomal status. The objective of this retrospective cohort study was to investigate the association between the chromosomal status on day 3 of embryo development and blas- tocyst morphology.
MATERIALS AND METHODS:
A total of 596 embryos obtained from 106 cycles of intra- cytoplasmic sperm injection (ICSI) followed by preimplantation genetic aneuploidy screening (PGS) were included in this retrospective study. We evaluated the relation- ship between blastocyst morphological features and embryonic chromosomal altera- tion.
RESULTS:
Of the 564 embryos with fluorescent in situ hybridization (FISH) results, 200 reached the blastocyst stage on day 5 of development. There was a significantly high- er proportion of euploid embryos in those that achieved the blastocyst stage (59.0%) compared to embryos that did not develop to blastocysts (41.2%) on day 5 (P<0.001). Regarding blastocyst morphology, we observed that all embryos that had an abnormal inner cell mass (ICM) were aneuploid. Embryos with morphologically normal ICM had a significantly higher euploidy rate (62.1%, P<0.001). As regards to the trophectoderm (TE) morphology, an increased rate of euploidy was observed in embryos that had nor- mal TE (65.8%) compared to embryos with abnormal TE (37.5%, P<0.001). Finally, we observed a two-fold increase in the euploidy rate in high-quality blastocysts with both high-quality ICM and TE (70.4%) compared to that found in low-quality blastocysts (31.0%, P<0.001).
CONCLUSION:
Chromosomal abnormalities do not impair embryo development as ane- uploidy is frequently observed in embryos that reach the blastocyst stage. A high-quality blastocyst does not represent euploidy of chromosomes 13, 14, 15, 16, 18, 21, 22, X and Y. However, aneuploidy is associated with abnormalities in the ICM morphology. Further studies are necessary to confirm whether or not the transfer of blastocysts with low-quality ICM should be avoided.
Table 3
Comparison of euploidy and aneuploidy rates according to blastocyst development and morphology
|
|---|
| Predictor variables | Dependent variables |
|---|
| Euploidy (%) | Aneuploidy (%) |
|---|
|
|---|
| Embryo development on D5 |
| Blastocyst | 118/200 (59.0) | 82/200 (41.0) |
| Non-blastocyst | 150/364 (41.2) a | 214/364 (58.8) a |
| Blastocyst morphology |
| ICM | | |
| Normal | 118/190 (62.1) | 72/190 (37.9) |
| Abnormal | 0/10 (0.0)b | 10/10 (100) b |
| TE | | |
| Normal | 100/152 (65.8) | 52/152 (34.2) |
| Abnormal | 18/48 (37.5) c | 30/48 (62.5) c |
| ICM+TE | | |
| Normal | 100/142 (70.4) | 42/142 (29.6) |
| Abnormal | 18/58 (31.0) d | 40/58 (69.0) d |
|
|---|
D5; Day five of development, ICM; Inner cell mass, TE; Trophectoderm, a; Significantly different from blastocyst group, b; Significantly different from normal ICM group, c; Significantly different from normal TE group and d: Significantly different from normal ICM+TE group.
沒有留言:
張貼留言