Clinical and Experimental Reproductive Medicine

  • 제32권1호
  • /
  • Pages.47-54
  • /
  • 2005
  • /
  • 2233-8233(pISSN)
  • /
  • 2233-8241(eISSN)
대한생식의학회 (The Korean Society for Reproductive Medicine)
권호 표지

2세포기로의 조기난할 배아 선발을 이용한 체외수정술의 임신율 증가

Improvement of Pregnancy Rate by the Selection of Early Cleavage Embryos to 2-cell Stage in Human IVF

  • 박세희 (좋은문화병원 불임의학연구소) ;
  • 주보선 (좋은문화병원 불임의학연구소) ;
  • 이수경 (좋은문화병원 불임의학연구소) ;
  • 김경서 (좋은문화병원 산부인과) ;
  • 문화숙 (좋은문화병원 산부인과)
  • Park, Sea Hee (Center for Reproductive Medicine, Good Moonhwa Hospital) ;
  • Joo, Bo Sun (Center for Reproductive Medicine, Good Moonhwa Hospital) ;
  • Lee, Su Kyung (Center for Reproductive Medicine, Good Moonhwa Hospital) ;
  • Kim, Kyung Sue (Department of Obstetrics and Gynecology, Good Moonhwa Hospital) ;
  • Moon, Hwa Sook (Department of Obstetrics and Gynecology, Good Moonhwa Hospital)
  • 발행 : 2005.03.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: Evaluation of embryos using early cleavage to 2-cell stage has been proposed, but a critical time-point for selecting embryos is unclear. The aim of the present study is to provide a guideline including critical time-point in the selection of early cleaving embryo for the reduction of multiple pregnancies as well as the increase of pregnancy rate in human IVF. Methods: This prospective study was performed in 116 cycles from 85 patients who underwent conventional IVF or ICSI at the infertility clinic of Good Moonhwa Hospital from January 2002 to December 2003. Early cleavage (EC) of embryos to 2-cell stage was assessed at 25 h and 27 h postinsemination/microinjection. Embryos that had early cleaved at each time point were designated as EC-1 and EC-2, respectively, while others were designated as non-early cleavage (NEC). Results: At least one early cleavage embryo was observed in 54 (46.6%) for the EC-1 and 84 (72.4%) for the EC-2 of the 116 cycles assessed. Clinical pregnancy rates (PR) were significantly higher in the EC-1 group (66.7%) compared to the EC-2 group (53.6%) or the NEC group (31.2%) (p<0.05). Significant improvement of the pregnancy rate was found when at least two or more embryos were early cleaved at 25 h postinsemination or when the proportion of early cleavage embryo at 25 h postinsemination was higher than 20% (p<0.05). Conclusion: The critical time-point for the selection of early cleavage embryos with high implantation potential is more effective in 25 h postinsemination/microinjection compared to 27 h. The proportion as well as number of early cleavage embryos is also an important factor for the prediction of pregnancy outcome and the chance of multiple pregnancies. These results demonstrated that the evaluation of early cleavage embryos to 2-cell stage is an easy, simple, and objective method for the selection of good quality embryos suitable for embryo transfer.

키워드

참고문헌

  1. Gerris J, De Neubourg D, Mangelschots K. Elective single day 3 embryo transfer halves the twinning rate without decrease in the ongoing pregnancy rate of an IVFIICSl programme. Hum Reprod 2002; 17: 2626-31 https://doi.org/10.1093/humrep/17.10.2626
  2. Hamberger L, Hazekamp I. Towards single embryo transfer in lVE. J Reprod lmmunol 2002; 55: 141-8 https://doi.org/10.1016/S0165-0378(01)00135-8
  3. De Sutter P, Van der Elat J, Coetsier T, Dhont M. Single embryo transfer and multiple pregnancy rate reduction in lVFIICSl: a 5 year appraisal. Reprod BioMed Online 2003; 6: 464-9 https://doi.org/10.1016/S1472-6483(10)62169-4
  4. Scott L, Smith S. The successful use of pronuclear embryo transfers the day following oocyte retrieval. Hum Reprod 1998; 13: 1003-13 https://doi.org/10.1093/humrep/13.4.1003
  5. Tesarik J, Greco E. The probability of abnormal preimplantation development can be predicted by a single static observation on pronuclear stage morphology. Hum Reprod 1999; 14: 1318-23 https://doi.org/10.1093/humrep/14.5.1318
  6. Ludwig M, Schopper B, A1-Hasani S, Diedrich K. Clinical use of a pronuclear stage score following intracytoplasmic sperm injection: impact on pregnancy rates under the conditions of the German embryo protection law. Hum Reprod 2000; 15: 325 -9 https://doi.org/10.1093/humrep/15.2.325
  7. Scott L. The biological basis of non-invasive strategies for selection of human oocytes and embryos. Fertil Steril 2003; 9: 237-49
  8. Gardner D. Development of serum-free media for the culture and transfer of human blastocysts. Hum Reprod 1998; 13: 218-25 https://doi.org/10.1093/humrep/13.suppl_4.218
  9. Milki AA, Hinckley MD, Fisch JD, Dasig D, Behr B. Comparison of blastocyst transfer with day 3 embryo transfer in similar patient populations. Fertil Steril 2000; 73: 126-9 https://doi.org/10.1016/S0015-0282(99)00485-9
  10. Van Blerkom J. Can the developmental competence of early human embryos be predicted effectively in the clinical IVF laboratory? Hum Reprod 1997; 12: 1610-4 https://doi.org/10.1093/oxfordjournals.humrep.a019597
  11. Behr B, Fisch JD, Racowsky C, Miller K, Pool TB, Milka AA. Blastocyst ET and monozygotic twinning. J Assist Reprod Genet 2000; 17: 349-51 https://doi.org/10.1023/A:1009461213139
  12. Da Costa ALE, Abdelmassih S, de Oliveira FG, Abdelmassih B, Abdelmassih R, Nagy ZP, et al. Monozygotic twins and transfer at the blastocyst stage after ICSI. Hum Reprod 2001; 16: 333-6 https://doi.org/10.1093/humrep/16.2.333
  13. Zollner U, Zollne P, Hartl G, Dielt J, Steck T. The use of a detailed zygote score after IVFIICSI to obtain good quality blastocysts: the German experience. Hum Reprod 2002; 17: 1327-33 https://doi.org/10.1093/humrep/17.5.1327
  14. Scott L. Pronuclear scoring as a predictor of embryo development. Reprod BioMed Online 2003; 6: 201 -14 https://doi.org/10.1016/S1472-6483(10)61711-7
  15. Shoukir Y, Campana A, Farley T, Sakkas D. Early cleavage of in-vitro fertilized human embryos to the 2-cell stage: a novel indicator of embryo quality and viability. Hum Reprod 1997; 12: 1531-6 https://doi.org/10.1093/humrep/12.7.1531
  16. Sakkas D, Shoukir T, Chardonnens D, Bianchi PG, Campana A. Early cleavage of human embryos to the two-cell stage after intracytoplasmic sperm injection as an indicator of embryo viability. Hum Reprod 1998; 13: 182-7 https://doi.org/10.1093/humrep/13.1.182
  17. Lundin K, Bergh C, Hardarso T. Early embryo cleavage is a strong indicator of embryo quality in human IVE. Hum Reprod 2001; 16: 2652-7 https://doi.org/10.1093/humrep/16.12.2652
  18. Bos-Mikich A, Mattos ALG, Ferrari AN. Early cleavage of human embryos: an effective method for predicting successful IVFIICSI outcome. Hum Reprod 2001; 16: 2658-61 https://doi.org/10.1093/humrep/16.12.2658
  19. Sakkas D, Percival G, D'Arcy Y, Sharif K, Afnan M. Assessment of early cleaving in vitro fertilized human embryos at the 2-cell stage before transfer improves embryo selection. Fertil Steril 2001; 76: 1150-6 https://doi.org/10.1016/S0015-0282(01)02901-6
  20. Fenwick J, Platteau P, Murdoch AP, Herbert M. Time from insemination to first cleavage predicts developmental competence of human preimplantation embryos in vitro. Hum Reprod 2002; 17: 407-12 https://doi.org/10.1093/humrep/17.2.407
  21. Wharf E, Dimitrakopoulos A, KhalafY, Pickering S. Early embryo development is an indicator of implantation potential. Reprod BioMed Online 2003; 8: 212-8
  22. Nagy Z, Liu J, Joris H. Time-course of oocyte activation, pronucleus formation and cleavage in human oocytes fertilized by intracytoplasmic sperm injection. Hum Reprod 1994; 9: 1743-8 https://doi.org/10.1093/oxfordjournals.humrep.a138786
  23. Van Wissen B, Wolf JP, Bomsel-Helmreich O. Timing of pronuclear development and first cleavages in human embryos after subzonal insemination: influence of sperm phenotype. Hum Reprod 1995; 10: 642-8 https://doi.org/10.1093/oxfordjournals.humrep.a136003
  24. Balakier H, MacLusky NJ, Casper RF. Characterization of the first cell cycle in human zygotes: implications for cryopreservation. Fertil Steril 1993; 59: 359-65 https://doi.org/10.1016/S0015-0282(16)55678-7
  25. Isiklar A, Mercan R, Balaban B, Alatas C, Aksoy S, Urman B. Early cleavage of human embryos to the two-cell stage. J Reprod Med 2002; 47: 540-4
  26. Balakier H, Sojecki A, Motamedi G, Librach C. Time-dependent capability of human oocytes for activation and pronuclear formation during metaphase II arrest. Hum Reprod 2004; 19: 982-7 https://doi.org/10.1093/humrep/deh158
  27. Jurisicova A, Casper RF, MacLusky NJ. HLA-G expression during preimplantation human embryo development. Proc Natl Acad Sci USA 1996; 93: 161-165
  28. Van Blerkm J, Davis PW, Lee J. ATP content of human oocytes and developmental potential and outcome after in-vitro fertilization and embryo transfer. Hum Reprod 1995; 10: 415-24 https://doi.org/10.1093/oxfordjournals.humrep.a135954
  29. Martin W, Dale B, Marino M, Matteo LD, Alviggi C, Pisaturo ML, et al. Mitochondrial aggregation patterns and activity in human oocytes and preimplantation embryos. Hum Reprod 2001; 16: 909-17 https://doi.org/10.1093/humrep/16.5.909
  30. Braude P, Bolton V, Moore S. Human gene expression first occurs between the four- and eight-cell stages of preimplantation development. Nature 1988; 332: 459-61 https://doi.org/10.1038/332459a0
  31. Lin DPC, Huang CC, Wu HM, Cheng TC, Chen CI, Lee MS. Comparison of mitochondrial DNA contents in human embryos with good or poor morphology at the 8-cell stage. Fertil Steril 2004; 81: 73-9 https://doi.org/10.1016/j.fertnstert.2003.05.005