含有胶冻状凝块精液的两种处理方法的比较研究  

A comparative study of two preferred methods for semen containing jelly-like clots

作　　者：袁景川[1] 蒋彦[1] 宋歌[1] 耿彩平[1] 孟繁玉[1] 刘俊山[1] 黄小龙 贾梦楠 林菲 YUAN Jingchuan;JIANG Yan;SONG Ge;GENG Caiping;MENG Fanyu;LIU Junshan;HUANG Xiaolong;JIA Mengnan;LIN Fei(The Center of Reproductive Medicine and Infertility,the Fourth Hospital of Shijiazhuang,Shijiazhuang 050011,Hebei,China)

机构地区：[1]石家庄市第四医院生殖医学中心,石家庄050011

出　　处：《中国性科学》2023年第5期29-32,共4页Chinese Journal of Human Sexuality

基　　金：石家庄市科学技术研究与发展计划(191201193)。

摘　　要：目的比较含有胶冻状凝块精液的两种不同处理方法对体外受精(IVF)周期结局的影响。方法选取2018年1月至2020年6月在石家庄市第四医院生殖医学中心接受IVF助孕患者中男方精液未见明显异常但含有胶冻状凝块的163例患者作为研究对象,分为单纯密度梯度离心法组(A组,n=78)和先瞬时离心去凝块后再行密度梯度离心法组(B组,n=85)。比较两组精液处理前后的活动精子百分率(活率)、前向运动精子百分率(活力)、精子正常形态百分率等;比较两组的补救单精子卵胞质显微注射(Re-ICSI)周期率及两组未行Re-ICSI周期的受精率、优质胚胎率、可利用囊胚率及临床妊娠率等。结果B组活率、活力、精子正常形态百分率、2PN受精率、可利用囊胚率均优于A组,Re-ICSI周期率则低于A组,差异均具有统计学意义(P<0.05)。结论针对含有胶冻状凝块的特殊精液,先瞬时离心去凝块后再行密度梯度离心法是更有效的分离精子的方法;该方法可显著降低短时受精Re-ICSI周期率,提高IVF周期2PN受精率及可利用囊胚率。Objective To compare the effects of using two different methods to treat semen containing jelly clots on the outcome of in vitro fertilization(IVF)cycles.Methods A total of 163 patients who received IVF assisted pregnancy in the Center of Reproductive Medicine and Infertility of the Fourth Hospital of Shijiazhuang from January 2018 to June 2020 were selected as research objects,and were divided into simple density gradient centrifuge group(Group A,n=78)and instantaneous centrifuge to remove clots followed by density gradient centrifuge group(Group B,n=85).The percentage of motile sperm(viability),the percentage of forward motile sperm(motility)and the percentage of normal sperm morphology before and after semen treatment were compared between the two groups.The periodic rate of the rescure-intracytoplasmic sperm injection(Re-ICSI),and the rate of fertilization,good embryo rate,available blastocyst rate and clinical pregnancy rate without Re-ICSI were compared between the two groups.Results The viability,motility,percentage of normal sperm morphology,2PN fertilization rate,and available blastocyst rate in group B were better than those in group A,and the Re-ICSI cycle rate was lower than that in group A,with statistical significance(P<0.05).Conclusions For the special semen containing gelatinous clots,it is more effective to separate sperm by instantaneous centrifugation and then density gradient centrifugation.The method can significantly reduce the Re-ICSI periodic rate of short-term fertilization and increase the 2PN fertilization rate and available blastocyst rate in IVF cycle.

关 键 词：胶冻状凝块 密度梯度离心法 受精率 可利用囊胚率 

分 类 号：R697[医药卫生—泌尿科学]