早期或晚期补救ICSI对IVF-ET早期胚胎发育和临床妊娠结局的影响  

Effect of early or late re-ICSI on early embryo development and clinical pregnancy results in IVF-ET

作　　者：孙凯[1] 王建业[2] 唐宁[2] 

机构地区：[1]济南军区总医院产科 [2]济南军区总医院生殖医学中心,山东济南250031

出　　处：《中国优生与遗传杂志》2017年第9期103-106,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的研究早期或晚期卵胞浆内单精子注射(ICSI)对体外受精(IVF)后移植前胚胎发育情况和移植后临床妊娠结局的影响,探讨补救ICSI的可行性和优化优化补救ICSI方案,改善体外授精-胚胎移植(IVF-ET)的临床妊娠结局。方法回顾性分析本中心2014年1月1日至2016年1月1日接受IVF-ET的患者的胚胎发育情况和临床妊娠结局,根据授精方式的不同分为ICSI组(A组)、早期补救ICSI组(B组,授精后6-8小时行ICSI)和晚期补救ICSI组(C组,授精18-20小时行ICSI)。对三组患者的基本情况、早期胚胎发育情况和临床妊娠情况分别进行统计分析;根据移植时胚胎发育阶段的不同,将卵裂期胚胎和囊胚分别进行讨论分析。结果 (1)对卵裂期胚胎来说:三组患者的年龄、不孕年限、Gn用量、基础FSH、移植日内膜厚度、获卵数、移植胚胎数、卵裂率和冷冻胚胎率均无统计学差异(P>0.05),但三组的受精率、D3优质胚胎率、D3可用胚胎率有非常显著的统计学差异(P≤0.001),而且三组的临床妊娠率有显著统计学差异(P=0.003);(2)对囊胚移植来说:三组组患者的年龄、不孕年限、Gn用量、基础FSH、移植日内膜厚度、获卵数、移植胚胎数和卵裂率没有统计学差异(P>0.05),但三组的受精率、D3优质胚胎率、D3可用胚胎率和可用囊胚率存在非常显著的统计学差异(P≤0.001),且三组的临床妊娠率存在统计学差异(P=0.046)。结论早期补救ICSI相比较于晚期补救ICSI,可以获得较好的胚胎发育和临床妊娠结局,但都逊色于普通ICSI。补救ICSI能获得相当的可用胚胎和临床妊娠,可以作为常规IVF受精失败或受精较差的补充,而且早期补救ICSI要优于晚期补救ICSI。Objective：To study the effect of early rescue ICSI（re-ICSI）or late re-ICSI on pre-transplanted embryo development and clinical pregnancy results after transplantation,to investigate the feasibility of early and late re-ICSI,to optimize the methods of re-ICSI and to improve the clinical pregnancy result of IVF-ET. Methods：Retrospective analysis of embryo development and clinic pregnancy results of patients who received IVF-ET treatment from January 1,2014 to January 1 2016 was done. According to fertilization methods,the patients were divided into ICSI group（group A）,early re-ICSI group（group B,ICSI was done 6-8 h after insemination）and late re-ICSI group（group C,ICSI was done 18-20 h after insemination）. Basic information,early embryo development and clinic pregnancy results were analyzed among the three groups. In addition,according to the embryo development stage during transplantation,cleavage embryos and blastocysts were set in different part to study. Results：（1） To cleavage embryos transplantation：the age of patient,duration of infertility,dosage of Gn used,basic FSH,thickness of endometrium,number of oocytes retrieved,number of embryo transplanted,cleavage rate and freezing embryo rate among the three groups had no statistical difference（P〉0.05）,while fertilization rate,Day 3 good quality embryo rate and Day 3 available embryo rate had very significant difference（P≤0.001）among the three groups and clinical pregnancy rate was significantly different（P=0.003）.（2） To blastocyst transplantation：the age of patient,duration of infertility,dosage of Gn used,basic FSH,thickness of endometrium,number of oocytes retrieved,number of embryo transplanted and cleavage rate among the three groups had no statistical difference（P〉0.05）,but fertilization rate,Day 3 good quality embryo rate,Day 3 available embryo rate and available blastocyst had very significant difference（P≤0.001）among the three groups and clinical pregnancy rate was statistically different（P=

关 键 词：体外受精 卵胞浆内单精子注射 胚胎发育 胚胎移植 临床妊娠 

分 类 号：R714.8[医药卫生—妇产科学]