两种GnRH类似物在体外受精-胚胎移植中对早期胚胎发育的影响  

Influence of two GnRH analogues upon early embryo development in vitro fertilizationembryo transfer

作　　者：陈希曦[1] 邓爱民[1] 黎淑贞[1] 陈晓燕[1] 梁细妹[1] 

机构地区：[1]江门市中心医院生殖中心,529030

出　　处：《国际医药卫生导报》2011年第20期2486-2490,共5页International Medicine and Health Guidance News

摘　　要：目的比较体外受精一胚胎移植（IVF—ET）中促性腺激素释放激素激动剂（GnRH—a）长方案与促性腺激素释放激素拮抗剂（GnRH—A）方案早期胚胎发育的多项指标，以阐明促性腺激素释放激素（GnRI-I）类似物对早期胚胎发育的影响。方法将100例卵巢储备正常的行IVF—ET助孕治疗患者随机分为GnRH—a组和GnRH—A组，比较两组的实验室结果、D2、D3不同卵裂细胞数胚胎的比例以及空泡、欠对称、多核及碎片胚胎的比例；比较两组新鲜周期及冷冻胚胎移植（FET）的妊娠与非妊娠移植不同卵裂细胞数胚胎的的比例。结果两组患者的正常受精率、正常受精卵裂率、可用胚胎率、优质胚胎率比较差异无显著性垆〉0．05）。GnRH—a组D2〉4细胞胚胎及D，8细胞胚胎比例高于GnRH—A组、而D2核胚胎率、D2、D3片胚胎率低于GnRH—A组，以上各率比较差异有显著性（P〈0．05）；GnRH—a组新鲜周期临床妊娠率高于GnRH—A组，比较差异有显著性（P〈0．05），而两组FET临床妊娠率比较差异无显著性（P〉0．05）。GnRH—a组新鲜周期、FET周期的妊娠组与非妊娠组移植胚胎细胞数比例差异无显著性（P〉0．05）。GnRH—A组新鲜周期、FET周期的妊娠组移植8一细胞胚胎比例高于非妊娠组，差异有显著性（P〈0．05）。结论GnRH—A方案早期胚胎分裂速度较GnRH—a方案慢，且多核、碎片胚胎的比例高于GnRH—a方案；GnRH—A方案新鲜周期、FET移植D38-细胞胚胎有助于提高临床妊娠率。Objective To compare the indicators of early embryo development of gonadotropin-releasing hormone antagonist （ GnRH - a ） long protocol with gonadotropin-releasing hormone agonist （ GnRH - A ）protocol, to investigate the influence of GnRH analogues upon early embryo development in vitro fertilization - embryo transfer （ IVF-ET ）. Methods 100 patients with normal ovarian reserve undergoing IVF-ET were classified into GnRHa group and GnRHA group randomly. Compared the laboratory results and the radio of blastomere number, vacuole, non-symmetry, muhinuclear, and fraction of D2,D3 embryo; and compared the radio of transfer-embryo＇ s cell number between pregnancy and nonpregnancy in fresh and frozen embryo transfer （ FET ） of two groups. Results The rates of normal fertility, normal cleavage, available embryo, and high-quality embryo were not significantly different between two groups（P 〉 0.05）. Otherwise, the radios of D2 muhinuclear-embryo and D2,D3 fraction-embryo of Group 1 were significantly lower than Group 2; the radios of D2 〉 4-cells embryo and D3 8-cells embryo of Group 1 were significantly more than Group 2, which reached statistical difference（P 〈 0.05）. The pregnancy rate in fresh embryo transfer of Group 1 was higher than Group 2, which there was statistical differences between two groups（P〈 0.05）. No statistical differences were observed on the pregnancy rates in FET between two Groups （P〉 0.05）. There was no significant differences on implantation rates and the radio of cell number of transfer-embryo between pregnancy and non-pregnancy in fresh embryo transfer of Group 1 （P〉 0.05）. The number of 8-cells embryo in pregnancy was more than non-pregnancy in Group 2 ; there was significant difference（P〈 0.05）. Conclusion Early embryonic cleavage of GnRH-A protocol was slower than that of GnRH-A long protocol; and the radios of multinuclear and fraction embryo of GnRH-A protocol were higher than GnRH-A long protocol. 8-cells embryo-transfer in fresh and

关 键 词：体外受精-胚胎移植 GNRH类似物 胚胎 

分 类 号：R714.8[医药卫生—妇产科学]