短时授精对IVF受精正常患者治疗结局的影响  

Effect of short co-incubation of gametes on clinical outcomes in patients with no barriers to fertilization during IVF-ET

作　　者：周亮[1] 王勇[1] 王锦凤[1] 肖露[1] 张春晖[1] 侯震晖[1] 钱卫平[1] 

机构地区：[1]北京大学深圳医院生殖医学科,深圳518036

出　　处：《生殖与避孕》2015年第3期196-200,共5页Reproduction and Contraception

基　　金：国家自然科学基金项目(项目批准号:30900817);深圳市科技计划项目(项目批准号:201302069;JCYJ201206 18;ZYC201006180435A)

摘　　要：目的:探讨短时授精对IVF受精正常患者体外受精-胚胎移植(IVF-ET)治疗结局的影响。方法:回顾性分析IVF受精率>60%患者的临床资料,按授精方案分为短时授精组(n=153)和常规受精组(n=180)。结果:IVF短时授精组和常规IVF组分别获卵1 619枚和1 986枚,分别有133名和152名患者接受了新鲜胚胎移植。组间女方年龄、基础FSH(b FSH)、b LH、b E2、Gn量、h CG注射日FSH水平、h CG注射日E2水平、h CG注射日LH水平、获卵数、卵子成熟度及移植日内膜厚度均无统计学差异。IVF短时授精组和常规IVF组的正常受精率(65.55%vs 67.84%)、正常卵裂率(98.02%vs 96.90%)、胚胎种植率(29.41%vs 27.84%)、临床妊娠率(44.36%vs 45.39%)、继续妊娠率(41.35%vs 42.76%)、流产率(5.45%vs 2.90%)和异位妊娠率(1.82%vs 2.90%)均无统计学差异,但是短时授精组的多原核受精率(14.56%)显著高于常规IVF组(6.19%),而短时授精组的优质胚胎率(33.51%)高于常规IVF组(28.99%)。结论:因IVF短时授精可避免常规IVF完全受精失败而逐渐在国内广泛应用,但其远期影响还有待进一步认识。Objective： To investigate the clinical significance of short co-incubation of gametes in patients with no barriers to fertilization during IVF-ET. Methods： IVF patients with fertilization rate 〉60% were collected in the study and divided into short co-incubations group （n=153） and traditional IVF group （n=180）. The parameters and clinical outcomes had been analyzed between above two groups. Results： The patients in short co-incubation group and traditional IVF group received 1 619 eggs and 1 986 eggs, and 133 patients and 152 patients accepted embryo-transfer in fresh cycles, respectively. There were no significant differences between the two groups in ages, basal FSH/LH/E_2 level, FSH/LH/E_2 level on hCG injection day, total dosage of Gn used, numbers of oocytes retrieved, maturation of oocyte and endometrial thickness in ET day. The rates of normal fertilization （65.55% vs 67.84%）, cleavage （98.02% vs 96.90%）, implantation （29.41% vs 27.84%）, clinical pregnancy （44.36% vs 45.39%）, ongoing pregnancy （41.35% vs 42.76%）, abortion （5.45% vs 2.90%） and ectopic pregnancy （1.82% vs 2.90%） between the two groups were not significantly different. However, polyspermy rate was significantly higher in short co-incubation group （14.56%） than in traditional IVF group （6.19%）, and short co-incubation group （33.51%） had more good-quality embryos than traditional IVF group （28.99%）. Conclusion： Short co-incubation of gametes combined with early rescue ICSI had been used widely for avoiding complete fertilization failure in traditional IVF. Long-term effects and indications of short co-incubation followed by early removal of granular cells should be further recognized and standardized.

关 键 词：短时授精 早期拆除颗粒细胞 多原核受精 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]