2-세포기로의 조기난할 배아의 선별시점이 체외수정술의 임신결과에 미치는 영향
Effects of critical time-point for selection of early cleaving 2-cell embryos on the pregnancy outcomes of IVF
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=목적: 2-세포기로의 조기난할에 대한 평가는 높은 착상능을 가진 배아의 선택을 위해 연구되어져 왔으나 아직까지 조기난할 배아 선택을 위한 정확한 관찰시점은 명확하지 않다. 본 연구의 목적은 다태임신을 빈도를 낮추고 체외수정으로 인한 임신 결과를 호전시키기 위해 조기난할 배아의 선별을 위한 기준을 제시하고자 시행되었다. 연구 방법: 총 190주기에서 2세포기로의 조기난할을 수정 후 25시간과 27시간에 관찰하였으며 각각의 조기난할 배아를 EC (early cleavage)-1, EC-2로 정의하였으며, 조기난할이 없는 배아들을 NEC (non-early cleavage)로 정의하였다. 통계학적 분석은 unpaired student t-test와 chi-square test를 이용하였으며, p<0.05인 경우를 통계적으로 유의성이 있다고 판정하였다.결과: 평가된 190주기 중 적어도 하나의 조기난할 배아가 관찰된 경우는 EC-1에서는 98주기 (51.5%), EC-2에서는 44주기 (23.2%)에서 관찰되었다. 임상적 임신율은 EC-1군에서 (58.2%) EC-2 (31.8%)군이나 NEC (22.9%)군에 비해 보다 확연히 높았다 (p<0.05). 임상적 임신율과 착상율은 적어도 하나 이상의 EC-1 배아가 있었을 때 증가되었고, 이러한 임신율과 착상율은 EC-1 배아의 수가 많아질수록 증가하였다. EC-1 배아를 이식하지 않았거나 하나만을 이식한 경우는 단태임신이 대부분이었다 (88.0%, 87.5%). 그러나 EC-1배아를 둘 이상 이식하였을 경우 다태임신의 비율이 40% 정도까지 증가되었다.
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