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胚胎质量评价在选择性单囊胚移植中是非常重要的,可能提高妊娠率且降低多胎妊娠率。目前应用最广泛的是形态学评价方法,包括卵母细胞、原核期、卵裂期和囊胚期评分。近几年,定向代谢分析被认为是评价胚胎质量的有效方法,包括丙酮酸、糖代谢、氨基酸、可溶性人白细胞抗原(HLA-G)等。进一步代谢产物分析,即通过分析胚胎培养过程中不同阶段的代谢产物变化来预测胚胎活力,也获得了较好的应用前景。仅从形态学和代谢分析不能确定染色体的异常,因此,进行染色体筛查已经成为选择活力胚胎的方法之一。总之,当前胚胎质量评估主要依赖形态学评估作为第一道评估标准,其他预测方法应用于临床还需要进一步研究。
Evaluation of embryo quality is important in selective single blastocyst transplantation, which may improve pregnancy rates and reduce multiple pregnancy rates. Currently the most widely used morphological evaluation methods, including oocytes, prokaryotic stage, cleavage stage and blastocyst score. In recent years, directed metabolic analysis is considered as an effective method to evaluate embryo quality, including pyruvate, glucose metabolism, amino acids, soluble human leukocyte antigen (HLA-G) and so on. Further analysis of metabolites, that is, predicting embryo viability by analyzing the changes of metabolites in different stages of embryo culture, also obtained a good application prospect. Chromosomal abnormalities have not been identified solely by morphological and metabolic analyzes, therefore screening for chromosomes has become one of the options for selecting viable embryos. In conclusion, the current assessment of embryo quality relies mainly on morphological assessment as the first assessment criterion, and other prediction methods for clinical use require further study.