显微穿刺时机对卵胞浆内单精子注射结局的影响  

Impact of the Insemination Timing on the Outcomes of Intracytoplasmic Sperm Injection

作　　者：黄仲英[1] 李尚为[1] 马黔红[1] 樊伟[1] 李蕾[1] 

机构地区：[1]四川大学华西第二医院生殖医学中心,成都610041

出　　处：《生殖与避孕》2009年第6期370-373,共4页Reproduction and Contraception

摘　　要：目的:探讨寻找实施卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)最佳显微穿刺时机。方法:单纯因男方因素不孕接受ICSI治疗的146例患者的167个周期,在注射hCG后36～38h取卵。在注射hCG后37～40h行ICSI为A组,共576个卵,在注射hCG后41～48h行ICSI为B组,共449个卵。观察和比较受精率、卵裂率、优质胚胎形成率及胚胎种植率。结果:A组ICSI卵的受精率和卵裂率分别为79.51%和97.38%,与B组的受精率(80.85%)和卵裂率(97.52%)比较无显著性差异(P>0.05)。优质胚胎率在A组达76.91%,高于B组(70.06%),差异有显著性(P<0.05)。A组和B组的胚胎种植率分别为18.91%和19.11%,无显著性差异(P>0.05)。结论:注射hCG后37～48h期间行ICSI,穿刺时间不影响受精率和卵裂率。在注射hCG后37～40h行ICSI可提高优质胚胎率,但对胚胎种植率无明显影响。Objective： To investigate the impact of the insemination timing on the outcomes of intracytoplasmic sperm injection and determine the optimal timing for ICSI. Methods： A total of 146 patients, 167 cycles with male factor infertility undergoing ICSI were included in this study. Oocytes were retrieved during 36-38 h after hCG administration. A total of 1 025 M H oocytes were allocated to two groups according to different time intervals between performing ICSI and hCG injection. In group A, ICSI was performed on 576 oocytes during 37- 40 h after hCG injection. And in group B, ICSI was performed on 449 oocytes during 41-48 h after hCG injection. Results： The fertilization rate was not significantly different between group A and group B （79.51% vs 80.85%, P〉0.05）, and so was the cleavage rate （97.38% vs 97.52%, P〉0.05）. The percentage of good quality embryos was significantly higher in group A than in group B （76.91% vs 70.06%, P〈0.05）. The implantation rate was 18.91% and 19.11% in group A and group B, respectively, with no significant difference. Conclusion： ICSI performed during 37-48 h after hCG injection could get fairly good fertilization rate and cleavage rate. Performing ICSI early during 37-40 h after hCG injection would increase the percentage of good quality embryos while not influence the implantation rate.

关 键 词：体外授精 胚胎移植 卵胞浆内单精子注射(ICSI) 受精时机 

分 类 号：R714.8[医药卫生—妇产科学]