受精方式、女方年龄、生育史和取卵数对体外异常受精的影响  

Effect of Fertilization Mode,the Woman抯 Age,Reproductive History and Numbers of Retrieved Oocytes on Abnormal Fertilization in Human IVF/ICSI

作　　者：习海涛[1] 陈华[1] 葛红山[1] 单丹[1] 吕杰强[1] 

机构地区：[1]温州医学院附属第二医院生殖中心,温州325000

出　　处：《生殖与避孕》2011年第11期746-750,共5页Reproduction and Contraception

摘　　要：目的:探讨人卵子体外受精后单原核(PN)和多原核胚胎形成的影响因素,为提高正常受精率探寻可行的方法。方法:回顾性分析1 004个IVF周期和250个ICSI周期,共计15 364个卵细胞资料,研究胚胎原核形成与体外受精方式、女方年龄、生育史、获卵数的关系。结果:①ICSI周期的1PN率明显高于IVF周期,而3PN和4PN形成率则明显低于IVF(P<0.05)。②当女方年龄>35岁时,1PN、3PN和4PN形成率均显著高于年龄≤35岁者(P<0.05);当女方年龄在28￣35岁时2PN(正常受精率)生成率最高(P<0.05),此年龄段的患者施行ICSI时3PN生成率也最高(P<0.05)。③女方无生育史的1PN形成率上明显高于有生育史患者(P<0.05)。④获取6￣10枚卵组,2PN形成率明显高于1￣5枚卵组和>20个卵组(P<0.05);而对于1PN、3PN、4PN形成率,获11￣15枚卵组明显高于其他获卵数组(P<0.05);而在获卵数>20枚时ICSI组2PN(正常受精率)生成率显著降低。结论:人体外受精正常与否受到受精方式、女方年龄、生育史和取卵数目等因素的影响,因此,在进行辅助生殖技术(ART)时应综合考虑这些因素,有助于提高正常受精率,降低异常受精率。Objective： To explore the affecting factors of abnormal fertilization in human IVF/ICSI.Methods： The 15 364 oocytes from 1 004 IVF cycles and 250 ICSI cycles were retrospectively analyzed by the fertilization mode,the age of women,reproductive history,the number of retrieved oocytes of the incidence of normal fertilization rate（2 pronuclear,2PN） and abnormal fertilization rate（1PN,3PN,4PN）.Results： 1） The incidence of 1PN rate was lower in the ICSI group than that in the IVF group,however,the incidence of 3PN/4PN fertilization rate was higher in the ICSI group than that in the IVF group.2） In the ICSI group the incidence of 3PN/4PN was significantly increased when the age of female was older than 35（P0.05）.3） The incidence of 1PN in the group of primary infertility was obviously more than that in the group of secondary infertility.4） Total normal fertility rate in the group of 6-10 retrieved oocytes was higher than that in the other groups（P0.05）,and the incidence rate of abnormal fertilization（1PN,3PN,4PN） in the group of 11-15 oocytes was singnificantly higher than that in the other groups（P0.05）.Conclusion： The affecting factors and fertilization mechanism are different between IVF and ICSI： considering multiple factors for every couple of infertility and optimal fertilization modality in IVF may decline the incidence of abnormal fertilization and improve the normal fertilizaton rate.

关 键 词：体外受精 胚胎 单原核(1PN) 3原核(3PN) 

分 类 号：R714.8[医药卫生—妇产科学]