钙离子载体A23187激活卵母细胞在卵胞质内单精子注射中的应用  

Artificial oocyte activation with calcium ionophore A23187 in intracytoplasmic sperm injection cycles

作　　者：周怡 李婷婷[1] 贾磊[1] 孙鹏[1] 张敏芳[1] 方丛[1] Zhou Yi;Li Tingting;Jia Lei;Sun Peng;Zhang Minfang;Fang Cong(Reproductive Medicine Research Center,the Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院生殖医学研究中心,广州510655

出　　处：《中华生殖与避孕杂志》2020年第5期374-380,共7页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金(81871214);国家重点研发计划(2017YFC1001603)。

摘　　要：目的分析Ca^2+载体A23187对卵胞质内单精子注射(ICSI)受精失败或受精低下患者受精及胚胎发育的影响。方法回顾性自身对照研究分析2010年1月至2018年1月期间在中山大学附属第六医院生殖医学研究中心,因前次ICSI受精失败或低下[双原核(2PN)受精率≤30%],再次行ICSI助孕时采用Ca^2+载体A23187激活的43名患者资料。根据前次受精情况将患者分为受精失败和受精低下组、射出精子组和睾丸精子组,激活周期与既往ICSI周期自身对照。结果受精失败、受精低下、睾丸精子和射出精子各组激活周期的2PN受精率显著高于既往ICSI周期(分别为41.9%比0,P<0.001;44.3%比16.5%,P<0.001;36.5%比13.5%,P=0.004;43.1%比11.1%,P<0.001);受精低下组和射出精子组激活周期每周期可移植胚胎数和优质胚胎数较既往周期提高(P均<0.05);激活周期最终获得9例健康活产婴儿。结论Ca^2+载体A23187辅助激活能够提高既往ICSI受精失败或低下患者的受精率,并能改善使用射出精子ICSI患者的胚胎情况及临床结局。Objective To analyze the effect of calcium ionophore A23187 on fertilization and embryonic development of mature oocytes in patients with intracytoplasmic sperm injection(ICSI)failure history or poor fertilization rate.Methods A total of 43 patients who were conducted artificial oocyte activation with calcium ionophore A23187 due to total fertilization failure or poor fertilization rate[two pronucleus(2PN)rate≤30%]in previous ICSI cycles,from January 2010 to January 2018 in Reproductive Medicine Research Center,the Sixth Affiliated Hospital of Sun Yat-sen University were included in this retrospective self-control research.Fertilization rate,embryo development and pregnancy outcomes were compared between activation cycles and ICSI cycles,respectively in fertilization failure group,poor fertilization group,ejaculated spermatozoa group and extracted-testicular spermatozoa group.Results In fertilization failure group,poor fertilization group,extracted-testicular spermatozoa group and ejaculated spermatozoa group,the 2PN fertilization rate of activation cycles significantly increased compared with standard ICSI cycles(41.9%vs.0,P<0.001;44.3%vs.16.5%,P<0.001;36.5%vs.13.5%,P=0.004;43.1%vs.11.1%,P<0.001).In poor fertilization group and ejaculated spermatozoa group,the average number of transplanting embryos and high-quality embryos in activation cycles were significantly higher than those in ICSI cycles(P<0.05).Nine healthy neonates were delivered after oocyte activation in 43 patients.Conclusion Calcium ionophore A23187 activation can improve fertilization rate in patients with failed or poor fertilization rate of ICSI cycles,and improve embryonic development and pregnancy outcomes of ICSI cycles using ejaculated spermatozoa.

关 键 词：卵胞质内单精子注射 Ca^2+载体A23187 卵母细胞激活 受精 

分 类 号：R714[医药卫生—妇产科学]