降低卵胞浆内单精子注射卵母细胞退化率的方法分析  

Analysis of methods to reduce the degeneration rate of oocytes in intracytoplasmic sperm injection

作　　者：蔡文涛 常庆玲 陈丽华[3] CAI Wentao;CHANG Qingling;CHEN Lihua(Reproductive Medicine Center,989th Hospital of PLA,Luoyang 471000,Henan,China;Department of Obstetrics and Gynecology Reproductive Medicine Center,the Second Hospital Affiliated to Military Medical University(Xinqiao Hospital),Chongqing 400037,China;Department of Obstetrics and Gynecology Reproductive Medicine Center,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院生殖医学中心,河南洛阳471000 [2]陆军军医大学第二附属医院(新桥医院)妇产科生殖医学中心,重庆400037 [3]河北北方学院附属第一医院妇产科生殖医学中心,河北张家口075000

出　　处：《中国性科学》2022年第7期75-79,共5页Chinese Journal of Human Sexuality

基　　金：河北省卫生厅科研基金项目(20180836);张家口市科技计划项目(1921041D)。

摘　　要：目的探讨卵胞浆内单精子注射(ICSI)过程中降低卵母细胞退化率的方法。方法选取2011年3月至2017年12月在中国人民解放军联勤保障部队第九八九医院就诊的278例行ICSI周期的患者作为研究对象,共296个周期。将其中29例患者的29个周期(卵母细胞为脆性卵膜卵母细胞)随机分为激光辅助组及对照组,其余249例患者的267个周期(卵母细胞为正常卵膜卵母细胞)作为正常组,并进行随机分配,分别利用不同内径的显微注射针行ICSI操作:78个周期纳入4.5μm组,70个周期纳入5.0μm组,119个周期纳入5.5μm组。比较各组受精和胚胎发育情况。结果脆性卵膜卵母细胞激光辅助组退化率显著低于对照组,正常受精率显著高于对照组(P<0.05);但两组卵裂率和第三天(D3)优胚率比较,差异无统计学意义(P>0.05)。正常卵膜卵母细胞经不同内径显微注射针行ICSI后,4.5μm组退化率显著低于5.0μm组及5.5μm组(P<0.05);三组正常受精率、卵裂率和D3优胚率比较,差异无统计学意义(P>0.05),但4.5μm组正常受精率略高于5.0μm和5.5μm组。正常卵膜卵母细胞退化率显著低于脆性卵膜卵母细胞的两组(P<0.05),正常受精率和D3优胚率显著高于脆性卵膜卵母细胞的两组(P<0.05);正常卵膜卵母细胞和脆性卵膜卵母细胞卵裂率比较,差异无统计学意义(P>0.05)。结论通过激光削薄透明带及采用4.5μm内径显微注射针可以有效降低卵母细胞退化率。Objective To explore the methods to reduce the degeneration rate of oocytes in intracytoplasmic sperm injection(ICSI).Methods 278 patients with ICSI cycles who were treated in the 989th Hospital of PLA from March 2011 to December 2017 were selected as the research subjects,with a total of 296 cycles.Among them,29 cycles of 29 patients were randomly divided into the laser assisted group and the control group,and 267 cycles of the rest 249 patients were taken as the normal group.They were randomly assigned to receive ICSI with injection pipettes of different diameter:78 cycles were included in the 4.5μm group,70 cycles were included in the 5.0μm group,and 119 cycles were included in the 5.5μm group.The fertilization and embryonic development were compared in each group.Results The degeneration rate of oocytes with fragile oolemma in laser assisted group was significantly lower than that in the control group,and the normal fertilization rate was significantly higher than that in the control group(P<0.05);However,there was no significant difference in the cleavage rate and high quality of D3 embryo rate(P>0.05).Normal oolemma oocytes were treated with ICSI by injection pipettes of different inner diameter,the degeneration rate of 4.5μm group was significantly lower than that of 5.0μm group and 5.5μm group(P<0.05);there was no significant difference in the normal fertilization rate,cleavage rate and high quality of D3 embryo rate among the three groups(P>0.05),but the normal fertilization rate in 4.5μum group was slightly higher than that ir 5.0μm group and 5.5μm group.The degeneration rate of normal oolemma oocytes was significantly lower than that of two groups of fragile oocytes(P<0.05),and the normal fertilization rate and high quality of D3 embryo rate were significantly higher than that of two groups of fragile oocytes(P<0.05).There was no significant difference in cleavage rate between normal oocytes and fragile oocytes(P>0.05).Conclusions The degeneration rate of oocytes could be effectively reduced b

关 键 词：卵胞浆内单精子注射 激光辅助 显微注射针 退化率 

分 类 号：R711[医药卫生—妇产科学]