人类体外受精中的异常受精  

Abnormal fertilization in human in vitro fertilization

作　　者：黄学锋[1] 张巍[1] 

机构地区：[1]温州医学院附属第一医院,温州325000

出　　处：《生殖医学杂志》2009年第3期184-186,共3页Journal of Reproductive Medicine

摘　　要：在人类体外受精（in vitro fertilization，IVF）技术中，卵子正常受精的标准是出现2个原核（PN）和2个极体（PB），通常在授精后12～18h通过光学显微镜观察。大约5％～15％的卵子可表现为异常的原核和极体数目，这常表明出现了异常的受精过程。但光学显微镜观察原核和极体结果并不能准确判断卵子的受精情况，因为第1极体可在观察前解裂成为碎片，The fertilization status of oocytes in human in vitro fertilization （IVF） is usually checked by light microscopy at 12-18 hrs of insemination. The presence of 2 pronuclei （PN） and 2 polar bodies （PB） indicates a normal fertilization process. Abnormal fertilization accounts for about 5 %-15 % of insemi- nated oocytes in IVF. Recent cytogenetie studies on the pronuclei and embryos from 0 or 1 PN oocytes defined under microscopy suggested that some of them turned out the normal diploidy embryos. It implies some oocytes indicative of abnormal fertiliation are tranferrable in certain circumstance. The oocytes with 3PN are the most common pattern of abnormal fertilization and are caused mostly by polyspermic fertilization in conventional fertilization （C-IVF） or by nonextrusion of second polar body in intraeytoplasmic sperm injection （ICSI）. The major mechanism of polyspermic fertilization in C-IVF is the damage of blockage to polyspermic fertilization, which may be correlated to high E2 level in hyperstimulation cycle, high concentration of inseminated sperm, immature or aged oocytes, abnormal cortical reaction and the damage of zona pellucida. High 3PN rate in an IVF cycle can be ameliorated in a subsequent cycle by adopting ICSI instead of C-IVF. The rescue enucleation procedure in polyspermic triploidy oocyte can be used to achieve a diploidy normal embryo and therefore a normal pregnancy, but it remains to be an experimental method due to potential error in defining correct male PN. The researches in abnormal fertilization of human IVF should provide insight into understanding the fertilization mechanism in the human and also significant clinical implication in human IVF treatment.

关 键 词：体外受精 异常受精 原核 极体 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学] R714.13[医药卫生—基础医学]