卵母细胞成熟率对ICSI周期优质胚胎移植后妊娠结局的影响  

Effect of oocyte maturation rate on pregnancy outcome of ICSI cycle with high quality embryo transfer

作　　者：李婷婷[1] 周怡 李思进 郭映纯 方丛[1] LI Ting-ting;ZHOU Yi;LI Si-jin;GUO Ying-chun;FANG Cong(Reproductive Medicine Center,the Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655;Sun Yat-sen University School of Medicine,Guangzhou 510000)

机构地区：[1]中山大学附属第六医院生殖医学中心,广州510655 [2]中山大学中山医学院,广州510000

出　　处：《生殖医学杂志》2021年第2期145-149,共5页Journal of Reproductive Medicine

基　　金：国家重点研发计划“生殖健康及重大出生缺陷防控研究”重点专项课题(2016YFC1000302,2017YFC1001603);国家自然科学基金(81871214)。

摘　　要：目的研究卵母细胞成熟率对卵胞浆内单精子注射(ICSI)有优质胚胎移植周期胚胎发育和妊娠结局的影响。方法回顾性分析2015年1月至2019年12月在中山大学附属第六医院生殖医学中心接受ICSI助孕的患者资料,拮抗剂方案或激动剂方案促排卵按照卵母细胞成熟率(OMR)分为A组(30%<OMR≤60%)和B组(OMR>60%),采用SPSS统计软件倾向性评分匹配年龄、AMH、AFC、获卵数后,A组349例和B组316例纳入分析。比较两组患者的胚胎发育情况及移植D3优质胚胎后的妊娠结局。结果两组患者间年龄、AMH水平、AFC、基础性激素水平、获卵数和移植胚胎数均无统计学差异(P>0.05),2PN受精率、优质胚胎率、胚胎种植率、临床妊娠率、早期流产率亦均无统计学差异(P>0.05)。与A组比较,B组可利用胚胎率(79.63%vs.73.43%)及可利用胚胎数[(4.61±2.19)vs.(2.85±1.46)]、优质胚胎数[(3.89±1.93)vs.(2.39±1.31)]显著升高(P<0.05)。结论随着OMR的升高,ICSI周期的可利用胚胎数、可利用胚胎率更高;当获得优质胚胎移植时,不同OMR患者的ICSI周期鲜胚移植妊娠结局无明显差异。Objective:To explore the effect of oocyte maturation rate on embryo development and pregnancy outcome in ICSI cycle with high quality embryo transfer.Methods:A retrospective analysis was made on patients who underwent ICSI assisted pregnancy in the Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-sen University from January 2015 to December 2019.The cycles with antagonist protocol or agonist protocol were divided into group A(30%<OMR≤60%)and group B(OMR>60%)according to the oocyte maturation rate(OMR).After age,AMH,AFC and number of oocytes retrieved were matched by the propensity score of SPSS statistical software,349 cycles in group A and 316 cycles in group B were included in the analysis.The embryonic development status and pregnancy outcome after transplantation of Day 3 high-quality embryos were compared between the two groups.Results:There were no significantly differences in age,AMH,AFC,basal sex hormone levels,number of oocytes retrieved and number of embryos transplanted between the two groups(P>0.05).The 2NP fertilization rate,high-quality embryo rate,embryo implantation rate,clinical pregnancy rate and early abortion rate were also not significantly different(P>0.05).The available embryo rate(79.63%vs.73.43%),number of available embryos[(4.61±2.19)vs.(2.85±1.46)]and high-quality embryos[(3.89±1.93)vs.(2.39±1.31)]in group B were significantly higher than those in group A(P<0.05).Conclusions:With the increase of oocyte maturation rate,the available embryos number and rate in ICSI cycle are higher.When high quality embryo transfer was obtained,there was no significant difference in pregnancy outcome of fresh embryo transfer in ICSI cycle with different OMR.

关 键 词：卵胞浆内单精子注射 卵母细胞成熟 优质胚胎 胚胎发育 妊娠 

分 类 号：R698.2[医药卫生—泌尿科学]