体外成熟卵母细胞及畸形精子症体外受精方式的探讨  

A study on the approach of in vitro fertilization for oocytes from in vitro mature and for teratozoospermmia

作　　者：杨琼[1] 童先宏[1] 刘雨生[1] 金仁桃[1] 骆丽华[1] 周桂香[1] 栾红兵[1] 宋影[1] 郭通航[1] 

机构地区：[1]安徽省立医院生殖医学中心,合肥市230001

出　　处：《实用医学杂志》2007年第14期2144-2146,共3页The Journal of Practical Medicine

基　　金：安徽省科技厅计划项目课题(编号:05023088)

摘　　要：目的:为体外成熟卵母细胞(IVM)及重度畸形精子症选择有效、安全、经济的受精方式。方法:一组为拟接受常规体外受精(IVF)改为IVM的患者,另一组为重度畸形精子症患者(改良巴氏染色正常形态精子<5%,密度>20×106/mL,a+b级精子≥50%)。如患者获未成熟卵母细胞数≥15,选择其1/3卵母细胞行常规IVF方式受精,余2/3卵母细胞行单精子卵胞浆内注射方式受精。比较同一患者同一周期不同受精方式的受精率、卵裂率、优质胚胎率。结果:两种受精方式的受精率、卵裂率、优质胚胎率均无明显差异,两组中共有4例临床妊娠。结论:(1)为防止超排卵发生的卵巢过度刺激而由常规IVF改为IVM时,若男方精液质量和形态均正常,可以选择常规IVF方式受精。(2)重度畸形精子症者若精液质量正常,亦可选择常规IVF方式受精。Objective To select a safe, inexpensive, and effective insemination approach for oocytes from in vitro mature （IVM） and for severe teratozoospermmia. Methods A group of patients undergoing an alternative IVM to the initial in vitro fertilization（IVF） and another group of patients with severe teratozoospermmia （normal forms 〈 5%; sperm concentration 〉 20 × 10^6/mL; 50% or more in grade a＋b）were included in this study. If 15 or more mature oocytes from IVM were retrieved, 1/3 of the oocytes were chosen for routine IVF and the remaining 2/3 underwent intracytoplasmic sperm injection. Rates of fertilization,cleavage, and embryo quality were compared between the two different insemination approaches for the same patient. Results There was no difference in rates of fertilization, cleavage, and embryo quality between the two procedures. 4 couples were clinically pregnant. Conclusion Conventional IVF can be applied either in the patients undergoing IVM for avoiding ovarian hyperstimulation caused by super ovulation and whose husbands have normal quality and forms of sperms, or in those with severe teratozoospermmia but whose sperms were normal in quality.

关 键 词：受精 体外 单精子卵胞浆内注射 体外成熟卵母细胞 畸形精子症 

分 类 号：R698.2[医药卫生—泌尿科学]