成熟卵子率对常规体外受精后胚胎形成率的影响  

Effect of oocyte maturation rates on available embryo rates after in vitro fertilization

作　　者：宋天然 石缨 张月莲 SONG Tianran;SHI Ying;ZHANG Yuelian(Department of Obstetrics,Gynecology and Reproductive Medicine,Air Force Medical Center,Air Force Medical University,PLA,Beijing 100142,China)

机构地区：[1]空军军医大学空军特色医学中心妇产与生殖科,北京100142

出　　处：《空军航空医学》2024年第2期128-132,共5页AVIATION MEDICINE OF AIR FORCE

摘　　要：目的观察成熟卵子(mature metaphase ovum,MⅡ)率对常规体外受精(in vitro fertilization,IVF)后胚胎形成率及MⅡ卵子利用率的影响。方法回顾性分析空军特色医学中心单腔取卵、常规IVF的408个周期,按MⅡ率分为6组:A组(≥90%)197例,B组(≥80%~90%)105例,C组(≥70%~80%)54例,D组(≥60%~70%)28例,E组(≥50%~60%)14例,F组(<50%)10例。对各组年龄、基础卵泡刺激素、基础窦卵泡、促性腺激素用量和天数、绒毛膜促性腺激素日雌二醇水平、促排方案构成比、获卵数、MⅡ卵子数、双原核(two pronuclears,2PN)率、可移植胚胎率及MⅡ卵子利用率进行比较。结果各组相比患者基本情况、促排方案构成比、促排过程、获卵数之间差异无统计学意义(P>0.05)。2PN率、可移植胚胎数、可移植胚胎率随MⅡ率降低而降低,差异有统计学意义(F=25.530、2.384、8.685,P<0.001、=0.038、<0.001),而MⅡ卵子利用率差异无统计学意义(F=0.316,P=0.903)。A组成胚率(44.33±18.97)%高于其余各组[B组(38.84±17.82)%,C组(36.34±18.21)%,D组(30.45±11.38)%,E组(25.21±11.38)%,F组(20.85±12.68)%],差异均有统计学意义(P=0.011、0.004、<0.001、<0.001、<0.001)。结论单腔取卵、常规IVF周期卵子成熟率与促排方案无关;随着卵子成熟率下降,正常受精率、可移植胚胎率均明显降低,特别是MⅡ率<70%时;但卵子成熟率未影响已成熟卵子质量。Objective To observe the effect of oocyte maturation rates[mature metaphase(MⅡ)oocytes rate,MⅡovum rate]on the embryo formation rate and MⅡovum utilization rate after in vitro fertilization(IVF).Methods The 408 cycles of single cavity oocyte retrieval and conventional fertilization(IVF)in Air Force Medical Center were retrospectively analyzed,which were divided into 6 groups according to the MⅡovum rate:197 in group A(an MⅡovum rate of≥90%),105 in group B(80%to 90%),54 in group C(70%to 80%),28 in group D(60%to 70%),14 in Group E(50%to 60%),and 10 in group F(<50%).These groups were compared with respect to age,basal follicle stimulating hormone(FSH),basal follicle,dosage of gonadotropin(Gn)and days of use,estradiol(E2)levels the day chorionic gonadotropin(HCG)was injected,constituent ratio of the stimulation schedule,number of oocytes retrieved,MⅡovum,two pronuclear(2PN)rate,available embryo rate,and MⅡovum utilization.Results There was no significant difference in conditions of patients,constituent ratio of the stimulation schedule,processes of ovulation and the number of oocytes retrieved between these groups(P>0.05).The 2PN rate,number of available embryos,and the available embryo rate decreased with the MⅡovum rate,and the difference was statistically significant(F=25.530,2.384,8.685,P<0.001,=0.038,<0.001).However,there was no significant difference in MⅡovum utilization(F=0.316,P=0.903).The available embryo rate of group A(44.33±18.97)%was significantly higher than that of the other groups[group B(38.84±17.82)%,group C(36.34±18.21)%,group D(30.45±11.38)%,group E(25.21±11.38)%and group F(20.85±12.68)%],and the difference was statistically significant(P=0.011,0.004,<0.001,<0.001,<0.001).Conclusion Oocyte maturation rates in single cavity oocyte retrieval and conventional fertilization cycles are not associated with the ovulation promotion protocol.As the oocyte maturation rate decreases,the rate of normal fertilization and available embryos decrease significantly,especially when the M�

关 键 词：体外受精 MⅡ卵子利用率 成熟卵子率 可移植胚胎率 

分 类 号：R711.6[医药卫生—妇产科学]