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대한생식의학회지 제32권 제1호 2010년
2세포기로의 조기난할 배아 선발을 이용한 체외수정술의 임신율 증가
좋은문화병원 불임의학연구소1, 산부인과2
박세희1, 주보선1, 이수경1, 김경서2, 문화숙2,
Improvement of Pregnancy Rate by the Selection of Early Cleavage Embryos to 2-cell Stage in Human IVF
Sea Hee Park1, Bo Sun Joo1, Su Kyung Lee1, Kyung Sue Kim2, Hwa Sook Moon2
1Center for Reproductive Medicine, 2Department of Obstetrics and Gynecology, Good Moonhwa Hospital
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). Conclusions: 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 : Early cleaving 2-cell embryos, Pregnancy outcomes
교신저자 : bosunjoo@hanmail.net
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