短时受精后早剥卵对胚胎质量及妊娠结局的影响  

Impact of Early Removal of Cumulus Cells from Cumulus-oocyte Complexes after Shortterm Insemination on Embryo Quality and Pregnant Outcome

作　　者：汪翔[1] 方丛[1] 贾磊[1] 

机构地区：[1]中山大学附属第六医院生殖医学研究中心,广东广州510655

出　　处：《中山大学学报（医学科学版）》2014年第3期390-395,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81070495);广东省自然科学基金(S2013010013404)

摘　　要：【目的】探讨短时受精后早期剥除颗粒细胞对体外受精胚胎质量及妊娠结局的影响。【方法】回顾性分析2012年在本中心助孕的有早剥卵的103个IVF周期与74个ICSI周期,以ICSI组为对照,比较两组的2PN受精率、多PN受精率、可利用胚胎形成率、卵裂期优质胚胎形成率、种植率和临床妊娠率,再以IVF周期中的卵子是否进行早剥分为两组,比较早剥对IVF周期中2PN受精率、多PN受精率、可利用胚胎形成率、卵裂期优质胚胎形成率、种植率和临床妊娠率的影响。【结果】在IVF周期中共有1 181枚卵子纳入研究,其中早剥卵子513枚,非早剥卵子668枚,在ICSI周期中共有619枚成熟卵子纳入研究。结果显示,IVF组的2PN受精率、卵裂期优质胚胎形成率低于ICSI组,多PN受精率高于ICSI组,差异有统计学意义(P<0.05);其余比较均无统计学差异。而IVF的全部卵子中,早剥卵子组的2PN受精率、多PN受精率、可利用胚胎形成率、优质胚胎形成率、种植率、临床妊娠率与非早剥组相比,均无统计学差异(P>0.05)。【结论】与传统ICSI相比,短时受精后早期剥除卵丘颗粒细胞并未降低可利用胚胎形成率;与常规IVF相比,早剥也未提高多PN受精率;早剥卵是安全的,并能够使受精情况不明的患者受益。[Objective] To discuss the impact of early removal of cumulus cells from cumulus-oocyte complexes （COCs） after short-term insemination on embryo quality and pregnant outcome.[Methods] To retrospectively analyze 103 IVF cycles and 74 ICSI cycles in our center in 2012.Oocytes undergoing ICSI was set as control,the 2PN rate,polypronucleate （PPN） rate,available embryo rate,good quality embryo of cleavage-stage rate,implantation rate and clinical pregnant rate between the ICSI group and IVF group were compared.In addition,the same indexes of data between early removal of cumulus cells group and not early removal of cumulus cells group were also compared.[Results] Totally,1183 oocytes in IVF cycles and 619 M Ⅱ oocytes in ICSI cycles were analyzed.In IVF cycles,513 oocytes were early stripped cumulus cells.The 2PN rate and good quality of cleavage stage rate of IVF group was significantly lower than ICSI group （P ＜ 0.05）,and PPN rate was significantly higher （P ＜ 0.05）,while no significant differences were found in PPN rate,available embryo rate,implantation rate and clinical pregnant rate （P ≥ 0.05）.And in IVF cycles,no differences of all the indexes between early removal of cumulus cells group and not early removal of cumulus cells group were found significant.[Conclusion] Compared with conventional ICSI,early removal of cumulus cells after short-term insemination does not decrease available embryo rate ; and neither does it increase PPN rate when compared with conventional IVF.The operation of early removal of cumulus cells is safe,and can benefit the patients with uncertain fertilization outcome.

关 键 词：短时受精 早剥卵 受精率 胚胎质量 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]