脱颗粒细胞时机对ICSI妊娠结局的影响  

Effect of oocyte denudation time on ICSI pregnancy outcomes

作　　者：董萌[1] 徐小延[1] 孔琳[1] 周飞飞[1] 梁晓茵 李萍萍[1] 谭季春[1] DONG Meng;XU Xiao-yan;KONG Lin;ZHOU Fei-fei;LIANG Xiao-yin;LI Ping-ping;TAN Ji-chun(Reproductive Medicine Center,Shengjing Hospital of China Medical University,Key Laboratory of Reproductive Disorders&Fertility Remodeling,Shenyang 110072)

机构地区：[1]中国医科大学附属盛京医院生殖医学中心,辽宁省生殖障碍与生育力重塑重点实验室,沈阳110072

出　　处：《生殖医学杂志》2020年第8期991-995,共5页Journal of Reproductive Medicine

基　　金：国家重点研发计划“生殖疾病防治规范化体系建立”项目子课题(2018YFC1002105)。

摘　　要：目的探讨取卵后脱颗粒细胞的时机对ICSI妊娠结局的影响。方法回顾性分析2013年1月至2017年12月在中国医科大学附属盛京医院生殖中心行ICSI治疗的2638周期患者的临床资料。所有纳入的周期均采用自体卵母细胞。精确记录取卵、脱颗粒细胞及ICSI时间。取卵到脱颗粒细胞时间定义为T1,脱颗粒细胞到ICSI时间定义为T2,将T1、T2分别分成三组:T1:A1组(<1 h,422周期),A2组(1~2 h,1412周期),A3组(2~4 h,804周期);T2:B1组(<1 h,605周期),B2组(1~2 h,1320周期),B3组(2~4 h,713周期)。分别比较两个时间段不同组别的实验室结果和妊娠结局。结果本研究共纳入2638个ICSI治疗周期。实验室结局:A1、A2与A3三组间MⅡ卵率、受精率、卵裂率、优质胚胎率比较均无显著性差异(P>0.05)。B1、B2与B3三组间MⅡ卵率、受精率、卵裂率、优质胚胎率比较均无显著性差异(P>0.05)。妊娠结局比较:A1、A2与A3三组间临床妊娠率、HCG阳性率、胚胎停育率、流产率、种植率和活产率比较均无显著性差异(P>0.05)。B1、B2与B3三组间临床妊娠率、HCG阳性率、胚胎停育率、流产率、种植率和活产率比较均无显著性差异(P>0.05)。结论取卵后4 h内进行脱颗粒细胞、脱颗粒细胞后4 h内进行单精子注射对妊娠结局均无显著影响。Objective:To evaluate the effect of oocyte denudation time on pregnancy outcome of ICSI.Methods:A retrospective investigation was made based on 2638 patients who underwent ICSI cycles in Shengjing Hospital Affiliated to China Medical University from January 2013 to December 2017.All patients used their autologous oocytes.Exact time of oocyte retrieval,denudation,and ICSI were recorded.The time period from oocyte retrieval to denudation was defined as T1,and the time period from denudation to ICSI was defined as T2.Both T1 and T2 were divided into three groups:T1 respectively:A1:<1 hour(422 cycles),A2:1-2 hours(1412 cycles),A3:2-4 hours(804 cycles);T2:B1<1 hour(605 cycles),B2:1-2 hours(1320 cycles),B3:2-4 hours(713 cycles).The laboratory results and pregnancy outcomes were compared among the groups.Results:A total of 2638 ICSI cycles were included in this study.There were no significant differences in MⅡrate,fertilization rate,cleavage rate and good-quality embryo rate among A1,A2&A3 groups and among B1,B2&B3(P>0.05).There were no significant differences in clinical pregnancy rate,HCG positive rate,embryonic diapaus rate,abortion rate,implantation rates and live birth rate among A1,A2&A3 groups and among B1,B2&B3 groups(P>0.05).Conclusions:Denudation performed within 4 hours after oocyte retrieval and ICSI conducted within 4 hours after denudation have no significant impact on pregnancy outcomes of ICSI cycles.

关 键 词：脱颗粒细胞 单精子注射 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]