卵母细胞滑面内质网聚集对卵胞浆内单精子显微注射周期妊娠和新生儿结局的影响  

Effect of Oocytes with Smooth Endoplasmic Reticulum Aggregates on the Pregnancy and Neonatal Outcomes in ICSI Cycles

作　　者：张旖旎 汪萌 高丽敏 席青松 朱丽霞 靳镭 ZHANG Yini;WANG Meng;GAO Limin(Reproductive Medicine Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430030,China;JIAI Genetic&IVF Institute,Obstertrics and Gynecology Hospital,Fudan University,Shanghai 200011,China)

机构地区：[1]华中科技大学同济医学院附属同济医院生殖中心,湖北武汉430030 [2]复旦大学附属妇产科医院集爱遗传与不育诊疗中心,上海200011

出　　处：《实用妇产科杂志》2022年第12期928-932,共5页Journal of Practical Obstetrics and Gynecology

基　　金：国家重点基础研究发展计划(973计划)(编号:2018YFC1002103)。

摘　　要：目的:探讨在卵胞浆内单精子显微注射(ICSI)周期中,卵母细胞滑面内质网聚集(SERa)对胚胎发育情况、妊娠结局和新生儿结局的影响。方法:回顾性分析2015年1月至2020年12月的ICSI周期,根据纳入和排除标准,共纳入SERa阳性(SERa+)周期组(至少有1个卵母细胞有SERa+)291例,与同时期的1302例SERa阴性(SERa-)周期(所有卵母细胞均无SERa)作为对照组进行比较。分析两组患者的体外受精-胚胎移植(IVF-ET)实验室指标、临床结局以及新生儿情况,包括MⅡ卵母细胞率、受精率、卵裂率、临床妊娠率、种植率、流产率、活产率以及围产期并发症等。结果:(1)两组患者的年龄、不孕年限、不孕类型、体质量指数(BMI)、卵泡刺激素(FSH)、窦卵泡数(AFC)、促排方案、促性腺激素(Gn)天数、Gn剂量以及获卵数比较,差异无统计学意义(P>0.05);(2)与SERa-周期组相比,SERa+周期组的MⅡ卵母细胞率以及囊胚形成率显著增加(P<0.05);(3)与SERa-周期组相比,SERa+周期组的活产率显著降低(P<0.05),流产率显著增加(P<0.05);(4)两组患者的受精、卵裂、临床妊娠、种植率和围产期并发症比较,差异无统计学意义(P>0.05)。结论:SERa的存在对ICSI周期的胚胎发育和妊娠结局有负面影响,但仍然有一定的发育潜能和利用价值。建议胚胎学家对SERa+卵子仍应考虑加以利用,但在临床上优先考虑来自SERa-卵母细胞的胚胎用于SERa+周期的移植。Objective:The objective of the study was to explore the effects of smooth endoplasmic reticulum aggregates(SERa)on embryonic development, pregnancy outcome and neonatal outcomes of embryos in ICSI treatments.Methods:This was a retrospective analysis of infertility couples who underwent ICSI treatment between January 2015 and December 2020.According to inclusion and exclusion criteria, 291 cases were included in the SERa+cycle group(at least one oocyte had SERa+)and 1302 cases were includedin SERa-cycle group(all oocytes had no SERa)as the control group.Laboratory indexes, clinical outcomes and neonatal conditions, including oocyte maturation, fertilization, cleavage, clinical pregnancy, implantation, miscarriage, live birth rates and perinatal complications, were compared between the two groups.Results:(1)There were no statistically significant differences in the characteristics including age, infertility duration, type of infertility, BMI,FSH,AFC,ovulation stimulation protocol, Gn days, Gn dose and the number of oocytes retrieved between the two groups(P>0.05).(2)Women who had SERa+oocytes in the cycles had higher oocyte maturation and blastocyst formation rates than those in the SERa-cycles(P<0.05).(3)The SERa+group had a significantly lower rate of live birth compared to the SERa-group(P<0.05).Moreover, the rate of miscarriage was significantly higher in the SERa+group than that in the SERa-group(P<0.05).(4)There were no significant differences in fertilization, cleavage, clinical pregnancy, implantation rates as well as perinatal complications between the SERa+group and SERa-group(P>0.05).Conclusions:The existence of SERa has a negative impact on the embryo development and pregnancy outcomes of ICSI cycles, while SERa+oocytes still have a specific potentiality of development.It is suggested that embryologists should give priority to embryos originating from SERa-oocytes for transfer in the SERa+cycles clinically, while SERa+oocytes should be considered for using.

关 键 词：卵母细胞 滑面内质网 卵胞浆内单精子注射 妊娠结局 胚胎发育 

分 类 号：R715.2[医药卫生—妇产科学]