齿轮状透亮致密透明带M_(Ⅰ)期卵母细胞患者行ICSI/Re-ICSI结局  

Pregnancy outcome of ICSI/Re-ICSI M_(Ⅰ) oocytes in gear-like transparent dense zona pellucida

作　　者：蒋彦[1] 耿彩平[1] 宋歌[1] 袁景川[1] 张旭慧 曹尧南 Yan Jiang;Caiping Geng;Ge Song;Jingchuan Yuan;Xuhui Zhang;Yaonan Cao(Reproductive Medicine Center,the Fourth Hospital of Shijiazhuang,Shijiazhuang Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]石家庄市第四医院河北医科大学附属妇产医院生殖医学中心,石家庄050011

出　　处：《中华生殖与避孕杂志》2022年第10期1075-1078,共4页Chinese Journal of Reproduction and Contraception

基　　金：石家庄市科学技术研究与发展计划(191200853)。

摘　　要：目的探讨齿轮状透亮致密透明带、卵周间隙小患者行卵胞质内单精子注射(intracytoplasmic sperm injection,ICSI)/补救ICSI(rescure-ICSI,Re-ICSI)妊娠结局。方法回顾性病例对照研究2015年1月至2020年6月期间于石家庄市第四医院生殖医学中心就诊的6对夫妇共8个周期卵子透明带异常,其中5对夫妇6个周期M_(Ⅰ)卵占比≥50%(部分卵M_(Ⅰ)阻滞),1对夫妇2个周期为全部卵M_(Ⅰ)阻滞。对M_(Ⅱ)卵行ICSI或体外受精(in vitro fertilization,IVF)短时受精,IVF短时受精完全受精失败,行Re-ICSI;对M_(I)卵同时行ICSI/Re-ICSI。比较M_(Ⅱ)卵和M_(Ⅰ)卵、全部卵M_(Ⅰ)阻滞和部分卵M_(Ⅰ)阻滞之间ICSI/Re-ICSI受精率、退化率、卵裂率、优质胚胎率、囊胚率。结果37枚M_(II)卵和65枚M_(Ⅰ)卵行ICSI/Re-ICSI,M_(Ⅰ)卵受精率、2PN受精率均低于M_(Ⅱ)卵[46.2%(30/65)比89.2%(33/37);32.3%(21/65)比83.8%(31/37),均P<0.001],两组均有优质胚胎及囊胚形成;全部卵M_(Ⅰ)阻滞与部分卵M_(Ⅰ)阻滞相比,M_(Ⅰ)卵受精率、退化率、优质胚胎率及囊胚形成率差异均无统计学意义(均P>0.05)。结论对透明带异常的M_(Ⅰ)卵占比高的患者行ICSI/Re-ICSI,可增加患者卵子利用率和可用胚胎。Objective To explore the pregnancy outcome of intracytoplasmic sperm injection(ICSI)/rescure-ICSI(Re-ICSI)patients with gear-like transparent dense zona pellucida and small perivitelline oocytes.Methods Totally 6 couples with abnormal zona pellucida came to the Reproductive Medicine Center of Shijiazhuang the Fourth Hospital from January 2015 to June 2020 were retrospectively case control analyzed.A total of 8 cycles had zona pellucida abnormalities,of which 5 couples,the proportion of M_(I) oocytes was≥50%(part oocytes M_(I) arrest)in 6 cycles and 1 couple(2 cycles)was all oocytes M_(I) arrest.ICSI or in vitro fertilization(IVF)short-term fertilization was performed on M_(II) oocytes with abnormal zona pellucida in controlled superovulation,IVF short-time fertilization failed completely,and Re-ICSI was performed.M_(I) oocytes were performed ICSI/Re-ICSI simultaneously.The ICSI/Re-ICSI fertilization rate,degeneration rate,cleavage rate,high-quality embryo rate and blastocyst rate were compared between the two groups of M_(II) oocytes and M_(I) oocytes,as well as all oocytes M_(I) arrest and part oocytes M_(I) arrest groups,respectively.Results Totally 37 M_(II) oocytes and 65 M_(I) oocytes underwent ICSI/Re-ICSI.M_(I) oocytes fertilization and 2PN fertilization rates were lower than M_(II) oocytes[46.2%(30/65)vs.89.2%(33/37);32.3%(21/65)vs.83.8%(31/37),all P<0.001].Both groups had high-quality embryos and blastocyst formation.Compared with part oocytes M_(I) arrest and all oocytes M_(I) arrest,there was no statistical difference in fertilization rate,degeneration rate,high-quality embryo rate and blastocyst formation rate between the two groups(all P>0.05).Conclusion ICSI/Re-ICSI for patients with abnormal zona pellucida with a high proportion of M_(I) oocytes can increase the patients'oocytes utilization rate and available embryos.

关 键 词：精子注射 细胞质内 M_(I)卵 透明带异常 

分 类 号：R714.8[医药卫生—妇产科学]