供精常规体外受精过程中多精受精的发生对生殖结局的影响  

Effect of polyspermy on reproductive outcome during routine in vitro fertilization with donor sperm

作　　者：赵小利 薛侠 师娟子 李明昭 ZHAO Xiao-li;XUE Xia;SHI Juan-zi;LI Ming-zhao(Reproductive Center,Northwest Women’s and Children’s Hospital,Xi’an 710003)

机构地区：[1]西北妇女儿童医院生殖中心,西安710003

出　　处：《生殖医学杂志》2022年第11期1494-1499,共6页Journal of Reproductive Medicine

基　　金：中华医学会生殖医学青年医师研究与发展项目(17020470716)。

摘　　要：目的 探讨多精受精(≥3PN)的发生对供精IVF(IVF-D)周期胚胎发育和临床结局的影响。方法 回顾性分析2014年1月至2020年12月在我院行IVF-D治疗的1 526例患者(共1 526个IVF-D周期)的临床资料。根据多精受精(≥3PN)率不同分为3组:多精受精率0%的为对照组(n=854),0%<多精受精率≤20%的为低频多精组(n=483),多精受精率>20%的为高频多精组(n=189),比较各组患者的基本资料、胚胎发育情况和妊娠结局。结果 各组间年龄、体质量指数(BMI)、不孕年限、基础FSH(bFSH)及促性腺激素(Gn)天数比较均无显著性差异(P>0.05);对照组的获卵数[(9.51±4.43)枚]显著低于低频多精组[(12.39±3.86)枚](P<0.05)。与高频多精组比较,对照组和低频多精组的正常受精率显著升高(65.69%、65.20%vs. 56.91%,P<0.05),而可用胚胎率显著降低(85.24%、85.75%vs. 88.63%,P<0.05);各组间卵裂率、优胚率及囊胚形成率比较均无显著性差异(P>0.05)。各组间移植日内膜厚度、移植胚胎数、单胚胎移植率和囊胚移植率比较均无显著性差异(P>0.05);对照组和低频多精组的种植率、临床妊娠率、多胎率、持续妊娠率及活产率略高于高频多精组,流产率和异位妊娠率略低于高频多精组,但差异均无统计学意义(P>0.05)。结论 常规IVF-D过程中,多精受精(≥3PN)的发生不影响胚胎的发育,但可能降低活产率。Objective:To explore the effect of the occurrence of polyspermy(≥3PN)on the embryo development and clinical outcomes in vitro fertilization with donor sperm(IVF-D).Methods:The data of 1526 patients(1526 IVF-D cycles)treated in our hospital from January 2014 to December 2020 were retrospectively analyzed.The patients were divided into three groups according to the rate of polyspermy(≥3PN):the control group with polyspermy rate of 0%(n=854),low frequency polyspermy group with polyspermy rate≤20%(n=483)and high frequency polyspermy group with polyspermy rate>20%(n=189).The basic data,embryo development and pregnancy outcomes of patients in each group were compared.Results:There were no significant differences in the female age,BMI,infertility duration,basal FSH(bFSH),and Gn days among three groups(P>0.05).The number of oocytes retrieved in the control group[(9.51±4.43)]was significantly lower than that in the low frequency polyspermy group[(12.39±3.86)](P<0.05).Compared with the high frequency polyspermy group,the normal fertilization rate in the control group and the low frequency polyspermy group was significantly higher(65.69%,65.20%vs.56.91%,P<0.05),while the available embryo rate was significantly lower(85.24%,85.75%vs.88.63%,P<0.05).There were no significant differences in cleavage rate,excellent embryo rate and blastocyst formation rate among groups(P>0.05).There were no significant differences in endometrial thickness,number of embryos transferred,single embryo transfer rate and blastocyst transfer rate between groups(P>0.05).The plantation rate,clinical pregnancy rate,multiple pregnancy rate,continuous pregnancy rate and live birth rate of the control group and low frequency polyspermy group were slightly higher than those of the high frequency polyspermy group,and the abortion rate and ectopic pregnancy rate were slightly lower than those of the high frequency polyspermy group,but the differences were not significant(P>0.05).Conclusions:In the process of IVF-D,the occurrence of polyspermy(≥3PN)ha

关 键 词：供精 多精受精 体外受精-胚胎移植 胚胎质量 临床结局 

分 类 号：R711.6[医药卫生—妇产科学]