扳机日血清雌激素不同水平时授精前后卵母细胞孵育时间对短时受精胚胎移植结局的影响  

Effects of oocyte incubation time before and after fertilization on transfer outcomes of fertilized embryo at the different levels of estrogen on trigger day undergoing short-term fertilization

作　　者：杨志伟 耿亚松 李国臻 陶林林 戴豪杨 戴芳芳 郑波 YANG Zhi-wei;GENG Ya-song;LI Guo-zhen;TAO Lin-lin;DAI Hao-yang;DAI Fang-fang;ZHENG Bo(Xingtai Infertility Specialist Hospital,Xingtai Reproduction&Genetics Specialist Hospital,Xingtai 054000)

机构地区：[1]邢台不孕不育专科医院/邢台生殖与遗传专科医院,邢台054000

出　　处：《生殖医学杂志》2022年第10期1366-1372,共7页Journal of Reproductive Medicine

基　　金：邢台市重点研发计划项目(2020ZC299)。

摘　　要：目的研究扳机日不同血清雌激素水平时卵母细胞取出后体外孵育时间和精卵共孵育时间对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法回顾性分析2017年1月至2020年12月在我院生殖中心行短时受精新鲜周期移植的1193例患者资料。根据扳机日雌激素(E_(2))水平中位数将患者分为A组(E_(2)≤11129.63 pmol/L)和B组(E_(2)>11129.63 pmol/L),并进一步依据取卵至授精卵母细胞孵育时间中位数细分为A1、B1组(卵母细胞孵育时间≤3 h组)和A2、B2组(卵母细胞孵育时间>3 h组)。比较4组患者基础资料和体外受精胚胎移植结局;采用Pearson相关性分析了卵母细胞孵育时间与精卵共孵育时间、正常受精率、多原核受精率、囊胚形成率、可移植胚胎率和优质胚胎率的相关性。采用二分类Logistic回归分析授精前后孵育时间对短时受精失败率、临床妊娠率、胚胎种植率和流产率的影响。结果四组患者间女方年龄、体质量指数(BMI)、HCG日子宫内膜厚度和胚胎移植个数均无显著差异(P>0.05)。A组获卵数、HCG日E_(2)和孕酮(P)水平显著低于B组(P<0.05),但A、B组内亚组间比较无显著差异(P>0.05);B2组优质胚胎率显著高于B1组(P<0.05),A2组优质胚胎率较A1组有增高趋势,但差异无统计学意义(P>0.05);HCG日E_(2)水平较低时A2组的临床妊娠率有增高趋势(63.32%vs.57.40%),但差异无统计学意义(P>0.05),A2组的种植率显著高于A1组(P<0.05);HCG日E_(2)水平较高时B1和B2两组临床妊娠率和种植率无显著差异(P>0.05)。随着卵母细胞孵育时间的增加精卵共孵育时间显著缩短(R=-0.318,P<0.001),多原核受精率显著降低(R=-0.006,P=0.008),精卵共孵育时间增加时优质胚胎的形成率显著降低(R=-0.057,P=0.012)。卵母细胞孵育时间与精卵共孵育时间均非短时受精卵母细胞是否受精失败、临床妊娠率、种植率和流产率的独立影响因素(P>0.05)。结论随着卵母细胞孵育�Objective:To investigate the effects of oocytes incubation time and gametes co-incubation time on transfer outcomes of fertilized embryo at the different levels of estrogen(E_(2))on the trigger day in the patients undergoing short-term fertilization.Methods:The data of 1193 patients underwent fresh transfer cycle with short-term fertilization in reproductive center of our hospital from January 2017 to December 2020 were retrospectively analyzed.According to the estrogen(E_(2))levels on the trigger day,the patients were divided into two groups:group A(E_(2)≤11129.63 pmol/L)and B(E_(2)>11129.63 pmol/L).Further,according to the median incubation time of oocytes from oocyte collection to fertilization,the patients were subdivided into group A1 and B1(oocyte incubation time≤3 hours group)and group A2 and B2(oocyte incubation time>3 hours group).The basic data and IVF-ET outcome of the four groups were compared.The correlations between the oocyte incubation time and co-incubation time of sperm and oocyte,the normal fertilization rate,the multipronuclear fertilization rate,the blastocysts formation rate,the transferable embryos rate and the high-quality embryos rate were analyzed by using Pearson correlation analysis.The correlations between the incubation time before and after fertilization and the fertilization failure rate,the clinical pregnancy rate,the implantation rate and the abortion rate were analyzed by binary Logistic regression analysis.Results:There were no significant differences in female age,body mass index(BMI),endometrial thickness on the HCG day and the number of embryo transferred among the four groups(P>0.05).The number of oocytes retrieved,E_(2)and progesterone(P)levels on the HCG day in group A were significantly lower than those in group B(P<0.05).However,there was no significant difference between the subgroups in group A and B(P>0.05).The high-quality embryo rate in group B2 was significantly higher than in group B1(P<0.05).The rate of high-quality embryo increased in group A2 was higher th

关 键 词：卵母细胞孵育时间 精卵共孵育时间 短时受精 胚胎结局 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]