不同促排卵方案中两种商品化培养液对胚胎体外发育及新鲜周期妊娠结局的影响比较  

Comparison of the effects of two kinds of commercial culture medium in different ovulation stimulation protocols on embryo development in vitro and the outcome of fresh cycle pregnancy

作　　者：苏杨 洪美虹 谢辉奕 SU Yang;HONG Mei-hong;XIE Hui-yi(Quanzhou Women's and Children's Hospital,362019 Quanzhou,China)

机构地区：[1]福建省泉州市妇幼保健院·儿童医院,泉州362019

出　　处：《妇产与遗传（电子版）》2022年第3期14-19,共6页Obstetrics-Gynecology and Genetics (Electronic Edition)

摘　　要：目的比较在不同促排卵方案下,Cook与Vitrolife培养基对辅助生殖技术体外胚胎培养的发育和妊娠结局的影响。方法回顾性分析2019年1月至2022年3月于泉州市妇幼保健院·儿童医院生殖医学中心进行体外受精/卵胞浆内单精子注射-胚胎移植的538例患者的临床资料。根据促排方案与胚胎培养基不同进行分组,卵泡期长效长方案分为Cook组(n=176)和Vitrolife组(n=180),黄体期长效长方案分为Cook组(n=32)和Vitrolife组(n=67),拮抗剂方案分为Cook组(n=36)和Vitrolife组(n=47)。比较同一促排卵方案,两种不同培养基培养的胚胎的正常受精率、卵裂率、第3天(D3)优质胚胎率、囊胚形成率、可利用囊胚率、临床妊娠率、胚胎种植率、早期流产率、异位妊娠率等的差异。结果三种促排方案中,Cook组的D3优质胚胎率(19.1%vs 12.6%,21.4%vs 13.7%,23.9%vs 16.8%,P<0.05)和可利用囊胚率(59.1%vs 43.5%,69.3%vs 55.2%,60.0%vs 45.4%,P<0.05)均明显高于Vitrolife组,差异有统计学意义。在卵泡期长效长方案中,Cook组的正常受精率、卵裂率及囊胚形成率明显高于Vitrolife组(65.4%vs 60.1%,98.8%vs 97.6%,68.0%vs 61.5%,P<0.05),差异有统计学意义。黄体期长效长方案和拮抗剂方案中,Cook组的正常受精率、卵裂率及囊胚形成率也有升高趋势,但差异无统计学意义。另外,在三组促排方案中,分别比较Cook组与Vitrolife组患者的临床妊娠率、胚胎种植率、早期流产率结果,差异均无统计学意义(P>0.05)。结论在不同促排方案中,Cook与Vitrolife培养基对新鲜周期的妊娠结局并无明显影响,但Cook培养基更有利于胚胎发育。Objective To compare the effects of Cook and Vitrolife culture medium on the development and pregnancy outcome of assisted reproduction embryo culture in vitro under different ovarian stimulation protocols.Methods A retrospective analysis was performed on the clinical data of538 patients who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)in the Reproductive Medical Center of Quanzhou Women’s and Children’s Hospital from January 2019 to March 2022.According to different ovarian stimulation protocols and embryo culture media,538 cases were divided into different groups.Follicular phase prolonged protocol was divided into Cook group(n=176)and Vitrolife group(n=180),luteal phase long protocol was divided into Cook group(n=32)and Vitrolife group(n=67),and antagonist protocol was divided into Cook group(n=36)and Vitrolife group(n=47).The differences of normal fertilization rate,cleavage rate,D3 highquality embryo rate,blastocyst formation rate,available blastocyst rate,clinical pregnancy rate,embryo implantation rate,early abortion rate and ectopic pregnancy rate among embryos cultured in the same stimulation protocol and two different media were compared.Results The D3 high-quality embryo rates and available blastocyst rates in Cook groups were significantly higher than those in Vitrolife groups(19.1%vs 12.6%,21.4%vs 13.7%,23.9%vs 16.8%,P<0.05)(59.1%vs 43.5%,69.3%vs 55.2%,60.0%vs 45.4%,P<0.05)with three stimulation protocols,and the differences were statistically significant.The normal fertilization rate,cleavage rate and blastocyst formation rate in the Cook group with follicular phase prolonged protocol were significantly higher than those in the Vitrolife group(65.4%vs 60.1%,98.8%vs 97.6%,68.0%vs 61.5%,P<0.05)in follicular phase prolonged protocol.The normal fertilization rate,cleavage rate and blastocyst formation rate also increased in Cook group with luteal phase long protocol or antagonist protocol,but the differences were not statistically significant.In addit

关 键 词：培养基 胚胎发育 妊娠结局 促排方案 

分 类 号：R714.8[医药卫生—妇产科学]