卵母细胞滑面内质网聚集体对临床结局和早期出生结局的影响  

Effect of smooth endoplasmic reticulum clusters in oocytes on clinical and perinatal outcomes

作　　者：王雪[1] 肖亚玲[1] 孙正怡[1] 甄璟然[1] 郁琦[1] 邓成艳[1] 周远征[1] 王含必[1] WANG Xue;XIAO Ya-ling;SUN Zheng-yi;ZHEN Jing-ran;YU Qi;DENG Cheng-yan;ZHOU Yuan-zheng;WANG Han-bi(Department of Gynecology Endocrine & Reproductive Center,Peking Union Medical College Hospital,Peking Union Medical College/Chinese Academy of Medical Sciences,Beijing 100730)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇科内分泌与生殖中心

出　　处：《生殖医学杂志》2019年第7期723-728,共6页Journal of Reproductive Medicine

基　　金：MMAAP基金会与默克雪兰诺中国生殖医学基金资助

摘　　要：目的分析内滑面内质网聚集(sERC)卵母细胞来源胚胎的发育潜能、移植后的临床和新生儿结局,进一步探讨sERC卵母细胞的可用性。方法本研究按照纳入和排除标准,将2016年12月至2018年8月在本院进行单精子卵母细胞胞浆内注射的患者根据获卵中是否出现sERC,分为sERC+周期组(A组,n=80)和sERC-周期组(B组,n=1492),比较两组促排卵过程中的临床数据和实验室数据,及两组的临床结局和新生儿结局。在A组中又根据卵母细胞是否出现sERC,进一步分为sERC+卵母细胞组(A1组,n=140)和sERC-卵母细胞组(A2组,n=416),分析两组的胚胎发育情况。再根据所移植的胚胎是否来源于sERC卵母细胞,分为:Ⅰ组(n=4),所移植胚胎全部来源于sERC+卵母细胞;Ⅱ组(n=10),所移植胚胎中的1枚胚胎来源于sERC+卵母细胞,1枚来源于sERC-卵母细胞;Ⅲ组(n=50),所移植胚胎均来源于sERC-卵母细胞;比较3组的临床结局。结果(1)sERC+卵母细胞的周期发生率为5.1%,sERC+卵母细胞的发生率为2.1%;(2)A、B两组的年龄、不孕年限和Gn用量以及HCG日E2水平和不同促排卵方案比例比较均无显著性差异(P>0.05);(3)A组的囊胚形成率显著低于B组(P<0.05),两组的成熟卵率、受精率、种植率、临床妊娠率、流产率和活产率比较均无显著性差异(P>0.05);(4)A组的新生儿出生体重略低于B组,但无显著性差异(P>0.05),两组的出生缺陷发生率相似(P>0.05);(5)A1组的受精率和囊胚形成率均显著低于A2组(P均<0.05);(6)Ⅰ、Ⅱ、Ⅲ组的种植率、临床妊娠率比较无显著性差异(P>0.05),3组均无畸形儿出生。结论卵母细胞内出现sERC可能对受精有影响,对早期卵裂无明显影响,会显著降低囊胚形成率,但本研究尚未发现sERC对妊娠结局和新生儿结局有不良影响。Objective : To analyze the developmental potential,clinical outcome and neonatal outcomes of smooth endoplasmic reticulum clusters (sERC) oocyte-derived embryos,and explore the usability of sERC oocyte. Methods : The patients who received ICSI in our hospital from December 2016 to August 2018 were divided into sERC + group ( n =80) and sERC - group ( n =1 492) according to the presence of sERC in the oocytes retrieved. The clinical data during ovulation induction,laboratory data and the clinical and neonatal outcomes were compared between the two groups. The oocytes in sERC + group were further divided into sERC + oocytes group ( n =140) and sERC - oocytes group ( n =416) according to the presence of sERC in oocytes. According to whether the transferred embryos originated from the sERC oocyte or not,they were divided into three groups:all transplanted embryos were derived from sERC + oocytes in group1 ( n =4),one embryo in the transplanted embryos was derived from sERC + oocytes,and one was derived from sERC - oocytes in group 2 ( n =10) and all transplanted embryos were derived from sERC - oocytes in group 3 ( n =50). The clinical outcomes were compared. Results : The incidence of sERC + oocyte cycle was 5.1%. The incidence of sERC + oocyte was 2.1%. There were no significant differences in age,infertility duration,gonadotropin dosage used,E 2 level on HCG day and the proportion of ovulation induction protocol between the two groups. Blastocyst formation rate in sERC + group was significantly lower than that in sERC - group ( P <0.05),but there were no significant differences in mature rate,fertilization rate,implantation rate,clinical pregnancy rate,abortion rate and live birth rate between the two groups( P >0.05). The birth weight of sERC + group was slightly lower than that of sERC - group,but there was no significant difference( P >0.05). The incidence of birth defects was similar between the two groups. The fertilization rate and blastocyst formation rate in sERC + oocyte group were significantly lower tha

关 键 词：卵母细胞 滑面内质网聚合体 胚胎发育 妊娠结局 出生结局 

分 类 号：R711.6[医药卫生—妇产科学]