ICSI周期未成熟卵母细胞24h体外成熟后受精 发育潜能和临床结局分析  

Fertilization and developmental potential after in vitro maturation of ICSI cycle immature oocytes at 24 hours and analysis on the clinical outcomes

作　　者：李丹[1] 余琼 任新玲[1] 江亚萍 张思佳 LI Dan;YU Qiong;REN Xin-ling;JIANG Ya-ping;ZHANG Si-jia(Center of Reproductive Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430000,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医学中心,湖北武汉430000

出　　处：《中国妇幼保健》2023年第21期4184-4188,共5页Maternal and Child Health Care of China

基　　金：国家自然科学基金资助项目(No.81701509)。

摘　　要：目的 研究胞浆内单精子注射(ICSI)周期中未成熟卵母细胞体外培养24 h成熟后进行ICSI的受精、发育潜能和临床结局,以期为未成熟卵母细胞的临床应用提供参考。方法 回顾性分析华中科技大学同济医学院附属同济医院生殖医学中心2018年1月—2021年10月行辅助生殖助孕治疗的不孕症患者的临床资料,以ICSI周期中未成熟卵母细胞比例>50%的69例患者作为研究对象,将263枚24 h体外成熟(IVM)的卵母细胞(B组)与来自相同周期的241枚体内成熟的同胞卵母细胞(A组)进行对比,分别比较两组胚胎的受精、发育潜能及临床结局。结果 B组成熟的卵母细胞(MII)比率59.63%明显高于A组的34.63%,差异有统计学意义(P<0.01),两组其余的基础资料比较差异均无统计学意义(P>0.05)。在受精方面,B组2原核(2PN)受精率50.57%与A组的51.45%接近;1PN率3.42%、3PN率3.42%和退化(DA)率16.73%与A组相比(分别为2.07%、3.32%、12.45%)呈升高趋势,但差异均无统计学意义(P>0.05)。B组第3天(D3)继培数68.42%较A组的50.81%明显增多,D3优胚率15.79%和可利用囊胚率20.88%较A组(分别为28.23%、39.68%)明显下降,差异均有统计学意义(P<0.05);第2天(D2)卵裂率90.98%、囊胚形成率34.07%、优质囊胚率8.79%与A组相比(分别为95.97%、49.21%、11.11%)呈下降趋势,但差异均无统计学意义(P>0.05)。A组复苏移植18例:妊娠3例(分娩1例,正在进行的妊娠2例);B组复苏移植15例:妊娠3例(分娩2例,正在进行的妊娠1例),分娩胎儿均健康无畸形及并发症。结论 对于MII卵母细胞较少的ICSI周期,未成熟卵母细胞体外培养24 h成熟后进行ICSI具有一定的临床应用价值,充分利用这部分卵母细胞可以提高卵子利用率和增加妊娠机会。Objective To research the fertilization and developmental potential after in vitro maturation of intracytoplasmic sperm injection(ICSI) cycle immature oocytes at 24 hours,analyze the clinical outcomes,and provide reference for clinical application of immature oocytes.Methods The clinical data of infertile patients treated with assisted reproduction in Center of Reproductive Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2018 to October 2021 were analyzed retrospectively,69 cases with proportion of ICSI cycle immature oocytes50% were selected as study objects,263 oocytes of in vitro maturation at 24 hours(B group) and 241 oocytes of in vivo maturation at 24 hours(A group) were compared,the fertilization and developmental potential,and clinical outcomes were compared.Results The proportion of mature oocytes in B group was 59.63%,which was statistically significantly higher than that in A group(34.63%)(P<0.01),there was no statistically significant difference in the other basic data between the two groups(P<0.05).The fertilization rate of two pronuclei(2PN) in B group was 50.57%,which was close to 2PN fertilization rate in A group(51.45%).1PN fertilization rate,3PN fertilization rate,and degradation rate in B group were 3.42%,3.42%,and 16.73%,respectively,which were higher than those in A group(2.07%,3.32%,12.45%,respectively),but there was no statistically significant difference between the two groups(P<0.05).The embryo development on the third day(D3) in B group was 68.42%,which was higher than that in A group(50.81%),D3 high-quality embryo rate and available blastocyst rate in B group were 15.79% and 20.88%,respectively,which were statistically significantly lower than those in A group(28.23%,39.68%,respectively)(P>0.05).The cleavage rate,blastocyst formation rate,and high-quality blastocyst rate on the second day(D2) in B group were 90.98%,34.07%,and 8.79%,respectively,which were lower than those in A group(95.97%,49.21%,11.11%,respectively),but there w

关 键 词：胞浆内单精子注射 未成熟卵母细胞 24 h体外成熟 受精 发育潜能 临床结局 

分 类 号：R714.8[医药卫生—妇产科学]