不同受精方式及精子来源对剩余胚胎继续发育能力影响的研究  

Effects of Fertilization Methods and Sperm Sources on the Developmental Capacity of Surplus Embryos

作　　者：徐志鹏[1] 孙海翔[1] 胡娅莉[1] 张宁媛[1] 王玢[1] 

机构地区：[1]南京大学医学院附属鼓楼医院生殖医学中心,江苏南京210008

出　　处：《中华男科学杂志》2009年第10期901-905,共5页National Journal of Andrology

基　　金：江苏省自然科学基金(BK2004095)~~

摘　　要：目的:探讨不同受精方式及ICSI中不同来源精子对胚胎继续发育能力的影响。方法:分析我中心2007年1月至2008年12月2135例患者剩余胚胎继续培养形成囊胚的情况,按不同受精方式分为IVF组(n=1 803)和ICSI组(n=332),其中IVF组再分为正常受精(n=1642)与补救受精组(n=161),ICSI组按精子来源不同再分为精液精子组(n=248)、附睾精子组(n=70)及睾丸精子组(n=14)。比较不同受精方式及不同来源精子获得剩余胚胎的囊胚形成率及优质囊胚率。结果:2 135例患者,共6 525枚剩余胚胎,经序贯培养后形成1 884枚囊胚(28.87%),其中优质囊胚974枚(51.70%)。IVF组剩余胚胎继续培养囊胚形成率(30.14%)显著高于ICSI组(21.40%,P<0.05)。IVF组优质囊胚率(52.44%)高于ICSI组(45.54%),但无显著差异(P>0.05)。IVF组中正常受精组囊胚形成率(31.04%)显著高于补救受精组(20.38%,P<0.05),正常受精组优质囊胚率(53.28%)显著高于补救受精组(38.54%,P<0.05)。ICSI组睾丸精子的剩余胚胎继续发育形成囊胚的比例(30.23%)显著性高于附睾精子(18.36%)与精液精子(21.76%,P均<0.05),睾丸精子组优质囊胚率(53.85%)也显著高于附睾精子(42.11%)与精液精子组(45.70%,P均<0.05)。结论:IVF组获得的剩余胚胎发育潜能高于ICSI组,IVF中正常受精组的剩余胚胎发育潜力高于补救受精组,ICSI组中睾丸精子获得剩余胚胎的继续发育潜能较高。Objective： To explore the effects of fertilization methods and sperm sources in intracytoplasmic sperm injection（ICSI） on the developmental capacity of surplus embryos.Methods： We analyzed the blastocyst formation of the surplus embryos from 2 135 patients,who were divided according to fertilization methods into an IVF（n=1 803） and an ICSI group（n=332）,the former again allocated to a normal fertilization（n=1 642） and a rescue fertilization group（n=161）,and the latter,according to sperm sources,to an ejaculated（n=248）,an epididymal（n=70） and a testicular sperm group（n=14）.The rates of blastocyst formation and good-quality blastocysts were compared between different fertilization methods and sperm sources.Results： A total of 1 884 blastocysts（28.87%） formed from 6 525 surplus embryos of the patients after sequential culture,of which 974（51.70%） were good-quality ones.The blastocyst formation rate of surplus embryos was significantly higher in the IVF（30.14%） than in the ICSI group（21.40%,P0.05）,the rate of good-quality blastocysts was also higher in the former（52.44%） than in the latter（45.54%）,but with no significant difference（P0.05）.The rates of blastocyst formation and good-quality blastocysts were significantly higher in the normal（31.04% and 53.28%） than in the rescue fertilization IVF group（20.38% and 38.54%,P0.05）,and in the testicular sperm ICSI group（30.23% and 53.85%） than in either the epididymal（18.36% and 42.11%） or the ejaculated sperm ICSI group（21.76% and 45.70%）（P0.05）.Conclusion： The development potential of surplus embryos was higher in IVF than in ICSI,in the normal than in the rescue fertilization IVF group,and in the testicular than in the epididymal and ejaculated sperm ICSI groups.

关 键 词：剩余胚胎 囊胚 精液精子 睾丸精子 附睾精子 辅助生殖技术 体外受精 卵细胞胞质内单精子注射 

分 类 号：R714.8[医药卫生—妇产科学]