卵母细胞滑面内质网聚集体对胚胎发育及妊娠结局的影响  

Effect of pregnancy outcomes and embryo development derived from smooth endoplasmic reticulum clusters in human oocytes

作　　者：张杨[1] 杨菁[1] 

机构地区：[1]武汉大学人民医院生殖中心,武汉430060

出　　处：《中国优生与遗传杂志》2015年第11期111-113,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨卵母细胞滑面内质网聚集体(SERC)对早期胚胎发育、妊娠情况的影响及其原因分析。方法回顾性性分析荆州市中心医院生殖中心于2012年1月至2013年12月行卵胞浆内单精子注射(ICSI)治疗共238周期,其中MII期卵母细胞存在SERC周期28周期(研究组),不存在SERC周期共210周期(对照组)。比较两组患者年龄、HCG日E2、FSH、P、LH水平、子宫内膜厚度、Gn总量、Gn天数、受精率、种植率、临床妊娠率、流产率等的差异。同时比较研究组中SERC+与SERC-卵母细胞的受精率、可利用胚胎率、优质胚胎率。结果两组患者在在年龄、病程、平均治疗周期数、内分泌基础水平、Gn首剂量、子宫内膜厚度、受精率、可利用胚胎率、种植率、临床妊娠率等方面无明显差异性(P>0.05);而与对照组相比,研究组在Gn总量及天数、HCG日E2水平、流产率等明显升高(P<0.05),优质胚胎率明显降低(P<0.05)。研究组中SERC+卵母细胞的优质胚胎率明显低于SERC-卵母细胞(P<0.05)。结论 ICSI周期卵母细胞SERC不利于体外胚胎发育及妊娠结局,而SERC现象可能与Gn长时间、大剂量刺激及HCG日高水平E2效应有关。Objective：Discuss the impact and the concerning causes on the pregnancy outcomes and embryo development derived from smooth endoplasmic reticulum clusters in human oocytes. Methods：Retrospective analysis of 150 patients included in 238 treatment cycles treated with ICSI in Reproductive Medicine Center of Jingzhou Central Hospital from Jan. 2012 to Dec. 2013. Within the 238 treatment cycles,28 cycles with SERC formed the study group,while the 210 cycles without SERC formed the control group. Comparisons between the two groups were made in the dimensions of ages,the level of estradiol,progesterone,luteinizing hormone and thickness of endometrium on HCG day,dose of Gn,duration of stimulation,fertilaization rate,implantation rate,clinical pregnancy rate and miscarriage rate to find out the differences.In addition,comparisons were made concerning the fertilaization rate,usable embryo rate,high-quality embryo rate between oocytes with SERC and those without SERC in study group. Results：There were not significant difference in ages,course of disease,basal level of endocrine,initial dose of Gn,thickness of endometrium,usable embryo rate,implantation rate and clinical pregnancy（P〈0.05）. But compared with the control group,the dose of Gn,duration of stimulation,the level of estradiol on HCG day and miscarriage rate were higher（P〈0.05）while high-quality embryo rate was lower（P〈0.05）. And the rate of high-quality embryo derived from occytes with SERC was lower than thoses without SERC（P〈0.05）. Conclusion：The SERC in occytes treated with ICSI was adverse to the embryo development in vitro and pregnancy outcomes. And the occurrence of SERC may be affected by long stimulating period,large dose of Gn and high estradiol level on HCG day.

关 键 词：卵母细胞 滑面内质网 胞浆内精子注射 胚胎 

分 类 号：R714.8[医药卫生—妇产科学]