卵母细胞的脱颗粒时间对短时受精后胚胎质量和妊娠结局的影响  

Effects of different time of oocyte cumulus cell removal on embryo quality and pregnancy outcome after short-term fertilization

作　　者：彭礼繁[1] 张小建[1] 廖梅旭[1] 李晓洁[1] 余鲲[1] 龙华洋 Peng Lifan;Zhang Xiaojian;Liao Meixu;Li Xiaojie;Yu Kun;Long Huayang(Department of Reproduction Medical Center,Eastern Hospital of Sichuan Academy of Medical Science·Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院辅助生殖医学中心,四川成都610072

出　　处：《中国男科学杂志》2020年第3期7-10,共4页Chinese Journal of Andrology

基　　金：四川省医学科研青年创新课题计划(编号:Q18028)。

摘　　要：目的探讨运用短时受精进行体外受精In vitro fertilization(IVF)时,去除卵子周围颗粒细胞的不同时间对短时受精后胚胎发育质量和妊娠结局影响。方法选择行IVF助孕的原发和继发不孕,且本周期移植的患者323例,按照卵母细胞不同的脱颗粒时间分为A组103例和B组220例。A组移植短时受精后3h去除颗粒细胞发育的胚胎;B组移植短时受精后20h后去除颗粒细胞发育的胚胎,比较两组胚胎的临床指标和发育参数。结果在年龄、不孕年限、原发/继发、Gonadotropin(Gn)用量、Gn使用天数、移植日的内膜厚度等临床资料及卵母细胞数、meiosis II(MII)卵数、2PN卵数、3 PN卵数、1-pronuclei(1 PN)卵数、2-pronuclei(2PN)分裂数、优质胚胎数、移植胚胎数、种植率等胚胎发育参数方面两组间没有显著性差异(P>0.05);但在3-pronuclei(3PN)卵数上两组间差异极显著(P<0.01),在种植率和临床妊娠率上两组间差异显著(P<0.05)。结论短时受精过程中,在确保患者正常受精的情况下,将剩余的卵母细胞保留颗粒细胞可以改善妊娠结局。Objective To investigate effects of different time of oocyte cumulus cell removal on embryo quality and pregnancy outcome after short-term in vitro fertilization.Methods 323 cases of patients that primarily or secondary infertility and were transplanted embryos in this cycle,which were randomly divided into group A(103 cases)and group B(220 cases).Group A patients were transplanted embryos which come from 3h of oocyte cumulus cell removal after short-term in vitro fertilization.Group B patients were transplanted embryos which come from 20h of oocyte cumulus cell removal after short-term in vitro fertilization.It was compared that clinic index and embryo development parameters of this two groups.Results The two groups were not almost significantly different on ages、infertility years、primarily or secondary infertility、endomembrane thickness in ET and oocyte rate、M II oocyte rate、2PN oocyte rate、3PN oocyte rate、1PN oocyte rate、2PN oocyte cleavage rate、quality embryo rate、number of embryos transferred、implantation rate(P>0.05).The two groups were high significantly different on 3PN oocyte rate(P<0.01).The two groups were almost significantly different on implantation rate and clinic pregnancy rate(P<0.05).Conclusion The pregnancy outcome was improved that patients were transplanted embryos which come from 20h of oocyte cumulus cell removal after short-term in vitro fertilization.

关 键 词：细胞脱颗粒 体外受精 胚胎发育 妊娠结局 

分 类 号：R321.33[医药卫生—人体解剖和组织胚胎学]