卵巢刺激周期促性腺激素用量对卵母细胞形态及临床结局的影响  

Impact of total gonadotropin dose on oocyte morphology and clinical outcome in ovarian stimulation cycles.

作　　者：刘浩[1] 金志魁 耿春惠 帅祖兵 邱文英 付学文 

机构地区：[1]解放军第173医院生殖中心

出　　处：《现代妇产科进展》2006年第4期295-298,共4页Progress in Obstetrics and Gynecology

摘　　要：目的：探讨卵巢刺激周期促性腺激素用量对卵母细胞形态及临床结局的影响.方法：将96个卵巢内单精子注射（ICSI）周期按促性腺激素用量分为高剂量组（＞3375IU）、中剂量组（2325～3375IU）、低剂量组（＜2325IU）,对1006个MⅡ期卵母细胞进行形态学（第一极体、卵周隙和卵浆形态）评估,比较各组卵母细胞形态、受精率、卵裂率、优质胚胎率和妊娠结局.结果：Gn高、中、低剂量组卵母细胞的Ⅲ～Ⅳ级极体形态发生率和卵周隙异常发生率间差异无统计学意义（P＞0.05）,高剂量组胞浆形态异常发生率明显高于低中剂量组（50.5%vs 35.8%、36.2%,P＜0.05）,高剂量组卵母细胞出现胞浆色深、粗颗粒的比例明显高于低中剂量组（27.1%vs 17.0%、18.1%,P＜0.05）.高剂量组卵母细胞卵周隙内出现颗粒比例也明显高于低中剂量组（40.2%vs 17.5%、23.2%,P＜0.01）.3组卵母细胞出现浆内空泡、浆内聚集体比例和相应受精率、卵裂率、优质胚胎率、临床妊娠率均较接近,差异无统计学意义（P＞0.05）,但高剂量组的流产率（50.0%）与低中剂量组（16.6%、12.0%）相比,有增加趋势.结论：卵巢刺激周期高促性腺激素用量（＞3375IU）可使卵母细胞出现较多的形态异常,主要是卵胞质颜色加深,有粗颗粒和卵周隙内颗粒,并有可能增加流产率.Objective：To investigate the impact of total gonadotropin dose on oocyte morphology and clinical outcome in ovarian stimulation cycles. Methods ：96 ICSI cycles were reviewed and graded into high-dose（〉3375IU） ,intermediate dose（2325 - 3375IU） and low-dose（〈2325IU） groups according to the total gonadotrophin dose in ovary stimulation cycles. 1006 metaphase oocytes were evaluated according to the morphology based on first polar body,perivitelline space and cytoplasmic morphology. The oocyte morphology, fertilization rate, cleavage rate, good quality embryo rate and clinical outcome were compared in three groups. Results：There were not significantly different in three groups that percentage of oocytes with abnormal first polar body of grade Ⅲ -Ⅳ and abnormal perivitelline space（P 〉0. 05）. But cytoplasmic of abnormal morphology in high dose group were significantly higher than those in intermediate dose and low-dose groups（50.5% vs 35.8% ,36.2% ,P 〈0.05）. Percentage of oocytes with dark cytoplasm, granular cytoplasm in high dose group were significantly higher than those in intermediate dose and low-dose groups （27.1% vs 17.0%, 18. 1%, P 〈0. 05 ）. Moreover, percentage of oocytes with pefivitelline space granularity were significantly higher than those in inter ate dose and low-dose groups（40. 2% vs 17.5% ,23.2% ,P 〈0. 01 ）.Fertilization rate,cleavge rate,good quality embryo rate,clinical pregnancy rate were similar in three groups（P 〉0.05） ;but the trend of abortion rate was increased in high dose group（50% ） than other groups（16.6% ,12.0% ）. Conclusion： High gonadotropin dose（ 〉 3375IU）are positively related to oocytes with dark cytoplasm, granular cytoplasm and perivitelline space granularity. And it may be correlated to a relatively higher abortion rate.

关 键 词：单精子注射 细胞质内 卵母细胞 促性腺激素类 临床结局 卵周隙内颗粒 胞浆粗颗粒 

分 类 号：R321[医药卫生—人体解剖和组织胚胎学] Q575.12[医药卫生—基础医学]