卵胞浆内单精子显微注射治疗周期中促性腺激素用药对胚胎发育潜能的影响  

Effect of gonadotropin administration on embryonic developmental potential during intracytoplasmic sperm microinjection

作　　者：胡婷婷[1] 汪伟伟 胡益祥 张颖 蔡艳萍 颜宏利 Hu Tingting;Wang Weiwei;Hu Yixiang;Zhang Ying;Cai Yanping;Yan Hongli(Department of Clinical Laboratory,the Fourth People's Hospital of Tongji University,Shanghai 200081,China;Reproductive Medicine Center,the First Affiliated Hospital of Navy Medical University,ShangHai 200433,China;Translational Medicine Center,Ruijin Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200001,China)

机构地区：[1]同济大学附属第四人民医院检验科,上海200081 [2]海军军医大学第一附属医院生殖医学中心,上海200433 [3]上海交通大学附属瑞金医院转化医学中心,上海200001

出　　处：《发育医学电子杂志》2023年第3期168-173,共6页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的探讨卵胞浆内单精子显微注射(intracytoplasmic sperm injection,ICSI)第3天新鲜移植周期中,促性腺激素(gonadotropin,Gn)用药天数及Gn总量与胚胎发育潜能的相关性,以及胚胎发育速度对妊娠结局的影响。方法回顾性分析2017年1月1日至2020年12月31日,在海军军医大学第一附属医院行ICSI助孕,并于胚胎发育第3天接受体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)的患者,共纳入299个周期。按照卵裂球数目的不同分为8细胞(8C)+7细胞(7C)组、8C+8C组、8C+9细胞(9C)组、8C+早期融合组(包括部分融合期胚胎和融合期胚胎)。以取卵日为第0天(D0),第3天(D3)上午即受精后67~69 h观察胚胎卵裂情况,移植2枚胚胎。记录女方的年龄、体质量指数(body mass index,BMI)、基础促卵泡刺激素(follicle-stimulating hormone,FSH)、不孕年限、Gn用药天数、Gn用量、周期获卵数、移植胚胎数、种植率、临床妊娠率、流产率和活产率。统计学方法采用单因素方差分析和χ^(2)检验。结果各组间的女方年龄、BMI、不孕年限、基础FSH比较,差异无统计学意义(P值均>0.05)。8C+7C组、8C+8C组、8C+9C组、8C+融合组的Gn用药天数分别为(10.9±2.8)、(10.3±2.2)、(10.7±2.3)、(8.5±2.2)d,Gn用量分别为(2172±615)、(2167±673)、(2332±796)、(1779±719)IU;8C+融合组的Gn用药天数、Gn用量均低于其他3组(Gn用药天数的t值分别为4.454、3.836、3.737,Gn用量的t值分别为2.328、2.490、2.779,P值均<0.05);8C+7C组、8C+8C组、8C+9C组间的Gn用药天数、Gn用量比较,差异无统计学意义(P值均>0.05)。8C+7C组、8C+8C组、8C+9C组、8C+融合组的临床妊娠率分别为58.6%(34/58)、55.3%(99/179)、44.4%(16/36)、76.9%(20/26),活产率分别为46.6%(27/58)、48.6%(87/179)、38.9%(14/36)、69.2%(18/26);8C+融合组的临床妊娠率和活产率均高于8C+8C组、8C+9C组(临床妊娠率的χ^(2)值分别为4.356、6.540,活产率的χ^(2)值分别为3.866、5.5Objective To investigate the correlation of gonadotropin(Gn)medication days and total Gn dosage with embryonic development potential on the third day of fresh transplantation cycles with intracytoplasmic sperm injection(ICSI),and the effect of embryo development speed on pregnancy outcomes.Method A retrospective analysis was performed in patients who received ICSI in the the First Affiliated Hospital of Navy Medical University,from January 1,2017 to December 31,2020.A total of 299 cycles of in vitro fertilization-embryo transfer(IVF-ET)on the third day of embryo development were included.According to the number of blastomes,they were divided into 8-cell(8C)+7-cell(7C)group,8C+8C group,8C+9C group and 8C+early fusion group(including partial fusion embryos and fusion embryos).Embryo cleavage was observed in the morning of day 0(D0)and day 3(D3),that is,67-69 h after fertilization,and two embryos were transferred.The woman's age,body mass index(BMI),folliclestimulating hormone(FSH),years of infertility,days of Gn medication,Gn,number of eggs obtained in a cycle,number of embryos transferred,implantation rate,abortion rate,clinical pregnancy rate and live birth rate were recorded.One-way analysis of variance andχ^(2)test were used for statistical analysis.Result There were no statistical differences in age,BMI,years of infertility and FSH among all groups(all P>0.05).The days of Gn medication in 8C+7C group,8C+8C group,8C+9C group and 8C+fusion group were(10.9±2.8),(10.3±2.2),(10.7±2.3)and(8.5±2.2)days,respectively.The dosage of Gn was(2172±615),(2167±673),(2332±796),and(1779±719)IU,respectively.The days of medication and dosage of Gn in 8C+fusion group were lower than those in the other three groups(t values of days of medication for Gn were 4.454,3.836 and 3.737,and t values of dosage for Gn were 2.328,2.490 and 2.779,respectively,all P<0.05).There were no statistical differences in the days of medication and dosage of Gn in 8C+7C group,8C+8C group and 8C+9C group(all P>0.05).The clinical pregnancy rates o

关 键 词：卵胞浆内单精子显微注射 促性腺激素 体外受精-胚胎移植 融合期胚胎 临床妊娠率 活产率 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]