短时二次取精在辅助生殖技术中的应用分析  

Analysis of the application of short-interval second ejaculation in assisted reproductive technology

作　　者：胡旭[1] 姚冠颖 张琍钧 韩中将 冯科[2] HU Xu;YAO Guanying;ZHANG Lijun;HAN Zhongjiang;FENG Ke(Department of Reproductive Medicine,Nanyang Central Hospital,Nanyang,Henan 473009,China;不详)

机构地区：[1]南阳市中心医院生殖医学科,河南南阳473009 [2]河南省人民医院生殖中心,河南郑州450003

出　　处：《中华全科医学》2024年第2期265-268,共4页Chinese Journal of General Practice

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210012)。

摘　　要：目的探讨取卵日短时二次取精对精液质量、最终授精方式、受精率及优胚率的影响。方法回顾分析2020年1月—2022年12月于南阳市中心医院生殖医学科拟行常规体外受精的32个取卵周期,男方均完成第1次取精(第1次取精精液优化后前向运动精子总数<1.0×10^(6)个)和短时二次取精(第1次取精后2 h内),分析2次精液质量及最终授精方式。对以上周期按最终授精方式分为体外受精(IVF,5例)、卵胞浆内单精子注射(ICSI,11例)、IVF+早补救ICSI(16例)3组,分析各组的受精率、卵裂率以及优胚率等。结果短时二次取精的精液体积显著小于第1次[(1.56±0.55)mL vs.(2.56±1.33)mL,t=5.847,P=0.038],精子浓度、总活力、前向运动及非前向运动精子比率与第1次取精相比差异均无统计学意义(P>0.05)。统计最终授精方式,IVF、ICSI、IVF+早补救ICSI比例分别为15.6%、34.4%、50.0%。3组女性患者的年龄、BMI、不孕年限、不孕类型及获卵数差异均无统计学意义(P>0.05)。IVF+早补救ICSI组的正常受精率和优质胚胎率显著低于ICSI组(P=0.009、0.010),余各组间的正常受精率、卵裂率、优质胚胎率差异均无统计学意义。结论短时二次取精虽能够有效补充前向运动精子总数,但行常规体外受精时早补救ICSI比例明显上升,一次取精精液质量欠佳时改行ICSI授精可能是更好的选择。Objective To investigate the effects of short-interval second ejaculation on semen quality,final fertilization methods,fertilization rate and high-quality embryo rate.Methods A retrospective analysis of 32 occyte retrieval cycles of conventional in vitro fertilization at the Reproductive Medicine Department of Nanyang Central Hospital from January 2020 to December 2022.The first ejaculation(The total number of progressive motility sperm was<1.0×10^(6) after the optimization of the first semen extraction)and the short-interval second ejaculation(within 2 hours after the first ejaculation)were performed in all the males.Semen quality and final fertilization methods were analyzed.The above cycles were divided into three groups according to the fertilization method:in vitro fertilization(IVF,n=5),intracytoplasmic sperm injection(ICSI,n=11),IVF+early rescue ICSI(n=16),and the fertilization rate,cleavage rate and high-quality embryo rate of each group were analyzed.Results The semen volume of short-interval second ejaculation was significantly lower than that of the first ejaculation[(1.56±0.55)mL vs.(2.56±1.33)mL,t=5.847,P=0.038],and the sperm concentration,total motility,and percentage of progressive motility and non-progressive motility sperms were not statistically significant between short-interval second ejaculation and first ejaculation(P>0.05).According to statistics on the final fertilization methods,the proportion of IVF,ICSI,IVF+early rescue ICSI accounted for 15.6%,34.4% and 50.0%,respectively.There were no significant differences in age,BMI,infertility years,infertility types and number of occytes obtained among the three groups(P>0.05).The normal fertilization rate and high-quality embryo rate of IVF+early rescue ICSI groups were significantly lower than those of ICSI groups(P=0.009,0.010),and there was no significant difference in normal fertilization rate,cleavage rate and high-quality embryo rate among other groups.Conclusion Although short-interval second ejaculation can effectively replenish the t

关 键 词：短时二次取精 精液质量 授精方式 受精率 优胚率 

分 类 号：R446.19[医药卫生—诊断学] R711.6[医药卫生—临床医学]