不同病因对卵母细胞透明带、胚胎发育和妊娠结局的影响  

Effect of Different Infertility Etiologies on Zona Pellucida,Embryo Development and Pregnancy Outcome

作　　者：成俊萍[1,2] 何冰 黄莉 谭卫红 薛林涛 王世凯 覃捷 陆凤花[2] 石德顺[2] 

机构地区：[1]广西自治区人民医院生殖医学与遗传中心,南宁530021 [2]广西大学动物繁殖研究所,南宁530005

出　　处：《生殖与避孕》2011年第4期270-276,共7页Reproduction and Contraception

基　　金：广西卫生厅重点课题(编号:重2010043);广西科学基金(桂科转0718005-3A和桂科青0640004)项目

摘　　要：目的:探讨女性不同病因对卵母细胞透明带、胚胎发育和妊娠结局等的影响。方法:回顾性分析因单因素不孕体外受精治疗的197个周期,以输卵管因素为对照组(n=145),比较多囊卵巢综合征(polycystic ovarian syndrome,PCOS)(n=25)、子宫内膜异位症(endometriosis,EMs)(n=19)和不明原因不孕症(n=8)等各组的受精率、种植率、妊娠率以及透明带双折射性和透明带厚度。结果:平均获卵数PCOS组(17.9±1.9枚)显著高于其它各组(对照组:11.3±0.6枚,EMs组:9.4±1.2枚和不明原因组:13.1±2.9)(P<0.01),其它各组无统计学差异(P>0.05);PCOS组、EMs组和不明原因组受精率(83.66%、75.40%、77.12%)、优质胚胎率(57.26%、51.14%、59.30%)、种植率(25.53%、17.39%、29.40%)和妊娠率(52.38%、41.18%、42.86%)与对照组(80.13%、58.99%、28.76%、43.70%)间无统计学差异(P>0.05),但EMs组各项指标均低于对照组。透明带双折射值各组间差异极显著(对照组:7.13±0.28,PCOS组:4.97±0.55,EMs组:3.67±0.75,不明原因组:14.19±1.41)(P<0.01),其中EMs组透明带双折射值最低。受精当日透明带厚度EMs组显著高于其它各组(对照组:18.84±0.07,PCOS组:18.48±0.17,EMs组:19.75±0.24,不明原因组:18.98±0.26)。结论:EMs对受精率、妊娠率和透明带双折射值等的影响最明显,透明带的双折射值和厚度可在一定程度上反映不同病因对卵母细胞发育潜力的影响。Objective：To explore effects of different etiologies for infertile woman on zona pellucida（ZP） of oocyte,embryo development and clinical result.Methods：A retrospective study was performed on 197 cycles underwent IVF-ET treatment.The retrieved oocyte number,fertility rate,implantation rate,pregnancy rate and zona pellucida birefringence（ZB） of polycystic ovarian syndrome（PCOS,n=25）,endometriosis（EMs,n=19） and zona pellucida birefringence（ZB） of polycystic ovarian syndrome（PCOS,n=25）,endometriosis（EMs,n=19） and unexplained infertilie（n=8） groups were separately compared with tubal factor infertile group（control group,n=145）.Results：The number of the retrieved oocytes from PCOS group（17.9±1.9） was significant higher than that in other groups（tubal factor infertile group：11.3±0.6,EMs group：9.4±1.2,unexplained infertility group：13.1±2.9）（P0.01）,and there was no difference among other groups.For the fertility rate,high-quality embryo ratio,implantation rate and pregnancy rate,no difference was found between the control（80.13%,58.99%,28.76%,43.70%） and the other groups POCS,EMs,unexplained infertile groups（83.66%,75.40 %,77.12%;57.26%,51.14%,59.30%;25.53%,17.39%,29.40%;52.38%,41.18%,42.86%）（P0.05）.However,all the examined parametersin EMs group were lowest among all groups.ZB was significantly different among all the groups（the control：7.13±0.28,PCOS：4.97±0.55,EMs：3.67±0.75,unexplained：14.19±1.41）（P0.01） and it was lowest in EMs group.The zona pellucida thickness of endometriosis at D0 in EMs group（19.75±0.24） was significantly higher than that in other groups（the control：18.84±0.07,POCS：18.48±0.17,unexplained：18.98±0.26）.Conclusion：The negative effects of EMs on fertility rate,pregnancy rate and the birefringence and thickness of zona pellucida are more obvious than those of other etiologies.The birefringence and thickness of zona pellucida can reflect the effects of different etiologies on the developmen

关 键 词：体外受精 病因 卵母细胞 透明带(ZP) 

分 类 号：R714.8[医药卫生—妇产科学]