激光鉴别存活精子行卵母细胞胞浆内单精子注射的应用效果  

The clinical analysis of the application effect of ICSI in laser identification of living sperm

作　　者：金锐 唐大伟 刘芳 任萌萌 马文叶 白刚 JIN Rui;TANG Dawei;LIU Fang;REN Mengmeng;MA Wenye;BAI Gang(Center of Reproductive Medicine,Yinchuan Maternal and Children Health Care Hospital,Yinchuan 750001,China)

机构地区：[1]宁夏银川市妇幼保健院,宁夏银川750001

出　　处：《宁夏医学杂志》2020年第5期409-411,共3页Ningxia Medical Journal

摘　　要：目的探讨利用激光鉴别存活精子在卵母细胞胞浆内单精子注射(ICSI)中的应用效果。方法随机选取生殖中心经睾丸穿刺活检后实施卵母细胞胞浆内单精子注射的患者15例作为观察对象,将其中获得成熟卵母细胞随机分为2组,激光组采用激光法来鉴别存活精子后实施ICSI,对照组操作依照人员经验选择尾部柔软的精子实施ICSI。比较2组卵母细胞的受精率、卵裂率、优质胚胎率。结果患者平均年龄(31.07±3.33)岁,平均不孕年限(4.27±2.12)年,促性腺激素(Gn)平均使用天数(12.33±0.98)d,Gn平均使用量(1 993.27±353.36)IU,HCG日E2水平(2 602.87±625.92)pg/mL;采用不同方法鉴别存活精子实施ICSI后,2组卵母细胞的成熟率分别为84.26%、84.88%,受精率分别为61.33%、61.64%,2组比较差异无统计学意义(P>0.05);激光组的卵裂率为97.83%,对照组的卵裂率为93.48%,2组比较差异无统计学意义(P>0.05);激光组优质胚胎率为60.47%,高于对照组的37.78%(P<0.05)。结论采用激光法可以有效鉴别严重弱精子症患者精子存活的情况,达到与目前技术一致的受精率,同时有助于提高ICSI后卵裂率和优质胚胎率,是严重弱精子症患者ICSI技术的有利辅助方法。Objective To investigate the effect of identification for viable sperm in intracytoplasmic sperm injection(ICSI)of oocytes by laser.Methods 15 patients who underwent intracytoplasmic sperm injection of oocytes after testicular puncture and biopsy were randomly selected as the observation objects.The patient’s mature oocytes were randomly divided into two groups,and the laser group used laser method to identify the living sperm and then ICSI was carried out,and the control group selected the sperm with soft tail according to the experience of operators to implement ICSI.The fertilization rate,cleavage rate and high-quality embryo rate were compared between two groups.Results Average age of patients was(31.07±3.33)year-old,average infertility time was(4.27±2.12)years,average time of administration was(12.33±0.98)days,average number of drugs was(1993.27±353.36)IU and the estrogen level of HCG injection day was(2602.87±625.92)pg/mL;There were no difference in scores of mature oocytes rate(84.33%vs.84.81%),fertilization rate(61.43%vs.61.19%)between two groups(P>0.05).The cleave rate was higher in laser group than that in control group(97.67%vs.92.68%),but no difference in scores between the groups(P>0.05).The quality embryo of laser group was higher in laser group than that in control group(60.90%vs.36.84%)(P<0.05).Conclusion ICSI by laser can effectively identify the sperm survival of patients with severe asthenospermia,and it can achieve the same fertilization rate as the current technology,and it is helpful to improve the cleave rate and high-quality embryo rate after ICSI,which is a favorable auxiliary method of ICSI technology for patients with severe asthenospermia.

关 键 词：精子存活 激光 睾丸穿刺 卵母细胞单精子注射 

分 类 号：R720[医药卫生—儿科]