精卵孵育时间对体外受精的围产儿结局的影响  

Effects of incubation timefor oocytes and sperm in vitro fertilization on the perinatal outcome

作　　者：林若芸[1] 冯贵雪[1] 张波[1] 周红[1] 汪彩珠[1] 陈焕华[1] 舒金辉[1] 黄映琴[1] LIN Ruoyun FENG Guixue ZHANG Bo et al(Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530003, Chin)

机构地区：[1]广西壮族自治区妇幼保健院生殖中心,南宁530003

出　　处：《中国生育健康杂志》2017年第5期431-434,共4页Chinese Journal of Reproductive Health

基　　金：广西自然科学基金面上项目(2013GXNSFAA019258)

摘　　要：目的比较精卵孵育时间对体外受精的围产儿结局的影响。方法回顾分析2013年1月—2014年12月在广西壮族自治区妇幼保健院生殖中心行常规体外受精的3 323例患者,共3 368个取卵周期,根据精卵孵育时间分成2组,精卵相互作用时间3～4 h者为孵育时间缩短组,传统受精组为传统受精方式,精卵过夜孵育16～18 h。比较两组的胚胎发育情况、妊娠结局及新生儿健康状况。结果孵育时间缩短组的正常受精率、优胚率、囊胚率及胚胎利用率分别为70.1%、49.7%、46.0%、52.1%,高于传统受精时间组(分别为:68.2%、48.4%、30.3%、50.9%,P<0.05)。但孵育时间缩短组的临床妊娠率、种植率、活产率虽稍高于传统受精组,但未达到统计学差异,两组单胎和双胎在孕周、出生体重、低出生体重儿和极低出生体重儿发生率、身长、Apgar评分上差异也无统计学意义,两组出生畸形率比较亦无统计学差异(P>0.05)。结论缩短精卵孵育时间能有效提高胚胎的发育潜能及胚胎的利用效率,但对围产儿未见明显影响。Objective To explore the effect of incubation time for oocytes and sperm in vitro fertilization on the perinatal outcome.Methods 3323 cases received conventional vitro fertilization in the reproductive medicine center of maternal and child health hospital of Guangxi Zhuang autonomous region were collected from January 2013 to December 2014.A total of 3368 oocyte retrieval cyles were allocated into two groups according to the incubation time of oocytes and sperm：the oocytes were incubated with the sperms for 3-4 hours in short-time IVF group（group A） and 16-18 hours in conventional fertilization group （group B）.The embryo development,pregnancy outcome and newborn health conditions between the two groups were compared.Results The rates of the normal fertilization rate,o shorten the incubation time （70.1% vs 68.2%）,excellent embryo rate （49.7% vs 48.4%）,blastocyst rate （46% vs 30.3%） and the utilization rate of embryos （52.1% vs 50.9%） were significantly better than the traditional fertilization time group （P 〈 0.05）.The rates of normal fertilization rate,the top embryo rate,blastocyst rate and utilization rate of embryo in group A were all higher than that of group B（70.1% VS 68.2%,49.7% VS 48.4%,46.0% VS 30.3%,52.1% VS 50.9%,respectively,P 〈 0.05）.Although a group of indicators in group A were slightly higher than group B,including the clinical pregnancy rate,implantation rate,live birth rate,there were no statistical significance.There were no statistical significance in gestatinal weeks,birth weight,length,Apgar score,rates of low birth weight and very low birth weight （P 〉 0.05）.Conclusion Shortening the incubation time for oocytes and sperm could effectively improve the embryonic development potential and the utilization efficiency of embryos,without evident effects on newborns.

关 键 词：精卵孵育 胚胎质量 发育潜能 种植率 围产儿结局 

分 类 号：R714.8[医药卫生—妇产科学]