短时受精并即刻脱颗粒细胞对IVF-ET治疗周期的影响  

Effect of short coincubation of gametes and removal of cumulus cells on outcome of in vitro fertilization and embryo transfer cycles

作　　者：刁英[1] 杨智敏[1] 谭兵兵[1] 葛斌[1] 杨名慧[1] 

机构地区：[1]遵义医学院第一附属医院生殖中心,563003

出　　处：《中国计划生育学杂志》2011年第2期106-108,122,共4页Chinese Journal of Family Planning

摘　　要：目的:了解体外受精-胚胎移植(IVF-ET)治疗中短时受精并即刻脱颗粒细胞对胚胎质量及结局的影响。方法:将316个IVF-ET周期按精卵受精时间不同及是否即刻脱颗粒细胞分为:短时受精并即刻脱颗粒细胞组(A组,精卵共孵育2h并即刻脱颗粒细胞)110个周期、短时受精并次日晨脱颗粒细胞组(B组,精卵共孵育2h并受精后18～19h脱颗粒细胞)108个周期和传统受精组(C组,精卵孵育过夜)98个周期。分别比较3组的受精率、多精受精率、卵裂率、优质胚胎率、妊娠率、胚胎种植率、流产率和分娩结局。结果:①3组的受精率、多精受精率、卵裂率和流产率差异无统计学意义(P>0.05);②A、B组的优质胚胎率、临床妊娠率和胚胎种植率显著高于C组(P分别<0.05或<0.01);③3组出生婴儿男女性别比例、新生儿出生体重差异无统计学意义(P>0.05),3组均无畸形胎儿出生。结论:①短时受精并即刻脱颗粒细胞不影响受精率、卵裂率和流产率,可提高优质胚胎率、临床妊娠率及胚胎种植率;②短时受精并即刻脱颗粒细胞能较准确判断卵子成熟度,观察第二极体是否排出,从而使补救卵细胞浆内单精子注射(ICSI)成为可能,进而可进一步严格控制ICSI适应证。Objective：To explore effects of short coincubation of gametes and removal of all cumulus cells on embryo quality and pregnancy outcome during in vitro fertilization cycles. Methods：A total of 316 cycles were randomly allocated to three groups,A （n=110,gamete co-incubating for 2 hours,then removing all cumulus cells）,B （n=108,gamete co-incubating for 2 hours,removing all cumulus cells 18-19 hours after insemination） and C （n=98,gamete co-incubating overnight）. The fertilization rate,polyspermy rate,cleavage rate,embryo quality,pregnancy rate,implantation rate,spontaneous abortion rate and outcome of delivery were evaluated. Results：There were no significant differences in the fertilization rate,polyspermy rate,cleavage rate and spontaneous abortion rate among the three groups （P0.05）. Compared with group C,significantly higher percentages were obtained in group A and B in terms of the high-quality embryo rate （62.96%,63.66% vs. 54.42%,P all0.01）,clinic pregnancy rate （41.82%,42.59% vs. 25.51%,P0.05,P0.01,respectively） and implantation rate （28.06%,28.27% vs. 19.90%,P all0.01）. There were no significant differences in the birth sex ratio and birth weight of neonates among the three groups （P0.05）. And no birth defects were found. Conclusion：The method of short coincubation of gametes and removal of all cumulus cells significantly improves embryo quality,the pregnancy and implantation rates. In addition,maturity of oocytes and discharge of the second polar body can be known exactly in order to decide if rescued ICSI should be practiced.

关 键 词：短时受精 脱颗粒细胞 体外受精 

分 类 号：R714.8[医药卫生—妇产科学]