胚胎实验室解读:获卵数对体外受精妊娠结局的影响  

Interpretation of the embryo laboratory:number of oocytes retrieved affects the pregnancy outcomes of in vitro fertilization

作　　者：高文怡 张东[2] 李采霞 杜娟[1] 张艳茹[1] 邓云[1] Gao Wenyi;Zhang Dong;Li Caixia;Du Juan;Zhang Yanru;Deng Yun(The 904 Hospital of the PLA Joint Logistics Support Force,Wuxi 214000,Jiangsu Province,China;State Key Laboratory of Reproductive Medicine,Nanjing Medical University,Nanjing 211166,Jiangsu Province,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院,江苏省无锡市214000 [2]南京医科大学生殖医学国家重点实验室,江苏省南京市211166

出　　处：《中国组织工程研究》2023年第24期3871-3876,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家重点研发计划项目(2018YFC1003402),项目负责人:张东;国家自然科学基金资助项目(32070840),项目负责人:张东。

摘　　要：背景:控制性超促排卵逐渐成为增加获卵数的常规手段,但关于获卵数是否越多越好一直存在争议,理想的获卵数区间目前尚未有统一的结论。目的:探讨获卵数对体外受精治疗周期中胚胎受精结局与临床妊娠结局的影响。方法:将489例进行体外受精治疗(包含常规体外受精与卵胞质内单精子注射)的患者按照获卵数进行分组,分以下5组:1-4枚组、5-8枚组、9-12枚组、13-16枚组、≥17枚组。比较各组受精率、卵裂率、可移植胚胎率、优质胚胎率以及临床妊娠结局,分析获卵数对体外受精结局的影响。结果与结论:获卵数与正常受精率、可移植胚胎率、优质胚胎率显著相关,过多或过少的获卵数均会导致正常受精率降低,异常受精率增加;可移植胚胎率与优质胚胎率下降;临床妊娠率、胚胎种植率与活产率下降。结果表明,过多或过少的获卵数会导致胚胎质量下降,影响体外受精临床结局,获卵数在5-16枚为宜,9-12枚为佳。临床医生在促排卵过程中,不能只以提高获卵数量为目标,应该追求足够多的高质量卵母细胞,为不同患者合理制定个性化促排方案。BACKGROUND:Controlled ovarian hyperstimulation has gradually become a routine method to increase the number of oocytes retrieved,but there has been controversy over whether the more oocytes retrieved the better.There is still no unified conclusion about the ideal range of egg retrieval number.OBJECTIVE:To explore the effect of number of oocytes retrieved on embryo fertilization outcome and clinical pregnancy outcome in fertilization in vitro treatment cycle.METHODS:489 patients undergoing in vitro fertilization treatment(including conventional in vitro fertilization and intracytoplasmic sperm injection)were divided into the following five groups according to the number of oocytes retrieved:1-4 group,5-8 group,9-12 group,13-16 group,and≥17 group.The fertilization rate,cleavage rate,transferable embryo rate,high-quality embryo rate,and clinicalpregnancy outcome were compared in each group,and the effect of the number of oocytes retrieved on the outcome of in vitro fertilization was analyzed.RESULTS AND CONCLUSION:The number of oocytes retrieved was significantly correlated with the normal fertilization rate,transferable embryo rate,and high-quality embryo rate.Too many or too few retrieved oocytes could lead to a decrease in the normal fertilization rate and an increase in the abnormal fertilization rate,a decrease in the rates of transferable embryos and high-quality embryos,a decrease in the clinical pregnancy rates,embryo implantation rates,and live birth rates.In conclusion,too many or too few oocytes retrieved can lead to the decline of embryo quality and affect the clinical outcome of in vitro fertilization.The number between 5 and 16 oocytes may be appropriate,while the number between 9 and 12 oocytes may be optimal.During ovulation induction,clinicians should not only aim to increase the number of oocytes retrieved,but should pursue enough high-quality oocytes to reasonably formulate personalized ovulation induction programs for different patients.

关 键 词：获卵数 受精率 可移植胚胎率 优质胚胎率 临床妊娠率 胚胎种植率 活产率 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R321