卵子透明带保存精子在第二代试管婴儿中的应用研究  

Study on the application of zona pellucida to the preservation of sperm in the second-generation in vitro fertilization

作　　者：苏占营[1] 张琴[1] 辜敏[1] 吴成亮[1] SU Zhanying;ZHANG Qin;GU Min;WU Chengliang(Jiujiang Maternal and Child Health Center,Jiujiang 332000,China)

机构地区：[1]九江市妇幼保健院,江西九江332000

出　　处：《临床医药实践》2024年第8期577-581,共5页Proceeding of Clinical Medicine

基　　金：江西省卫生健康委员会科技计划项目(项目编号:202311613)。

摘　　要：目的:探讨利用卵子透明带冷冻保存微量精子在第二代试管婴儿助孕中的应用效果。方法:回顾性分析2019年6月—2023年10月接受睾丸活组织检查取精助孕的40对夫妻,共计65个助孕周期的资料,根据患者助孕周期中精子来源分为A组(40个周期)和B组(25个周期)。A组采用女性取卵当日男方睾丸穿刺活检精子助孕,B组采用女性取卵当日利用卵子透明带冷冻保存的男性精子助孕(B组患者为上述经历了第一次新鲜睾丸精子助孕后,其中25对夫妻又开展了第2次助孕周期,第2次助孕周期时不再进行睾丸活组织检查取精,而是利用冷冻保存复苏后的精子助孕,共25个周期)。比较两组实验室各项指标[成熟卵母细胞百分率(MII卵率)、2原核胚胎受精百分率(2PN受精率)、2原核卵裂胚胎百分率(2PN卵裂率)、卵裂期优质胚胎百分率(D3优胚率)、囊胚形成率、临床妊娠率],25对接受两次助孕史的夫妻依据前后两次助孕的精子来源,分为新鲜睾丸精子和解冻精子两部分,比较其上述实验室各项指标的差异性。结果:两组MII卵率、2PN受精率、2PN卵裂率、D3优胚率、囊胚形成率、临床妊娠率比较,差异均无统计学意义(P>0.05);另外25对夫妻前后接受两种不同来源精子助孕的指标比较,差异也均无统计学意义(P>0.05)。结论:利用卵子透明带冷冻保存微量精子在无精症患者中能够在保证无新鲜睾丸穿刺精子的情况下得到类似的临床结局,同时可减少男性反复睾丸活组织检查的痛苦及创伤,该方法确保极少量精子在冷冻-复苏过程中不会丢失,此方法容易获取高质量解冻精子。Objective:To explore the effect of cryopreservation of microsperm by egg zona in the second generation of in vitro fertilization pregnancy.Methods:The data of 40 couples who received testicular biopsy to assist pregnancy from June 2019 to October 2023 were retrospectively analyzed,and they were divided into group A(40 cycles)and group B(25 cycles)according to whether or not the biopsied sperm were frozen through the oocyte zonalis.Group A was assisted by fresh testicular punctured sperm,group B was assisted by cryopreservation of resuscitated sperm with ovum pellucidum.Among them,25 couples received two assisted pregnancies(fresh testicular sperm and frozen resuscitated sperm were used for 1 cycle each).Laboratory indicators[percentage of mature oocytes(MII egg rate),percentage of two prokaryotic embryo fertilization(2PN fertilization rate),the percentage of embryos with two prokaryotes and cleavage(2PN ovulation rate),percentage of good quality embryos at cleavage stage(D3 excellent embryo rate)]were compared between the two groups.Meanwhile,25 couples who had received two assisted pregnancies were divided into fresh testicular sperm and thawed sperm,and the differences of laboratory indicators between the two parts were compared.Results:There was no statistical significance in MII egg rate,2PN fertilization rate,2PN cleavage rate,D3 fine embryo rate,blastocyst formation rate and clinical pregnancy rate between the two groups(P>0.05).There was no statistical significance in laboratory indicators of the same couple receiving two kinds of sperm from different sources for assisted pregnancy(P>0.05).Conclusion:Cryopreservation of microsperm with zona pellucida can achieve similar clinical outcomes in azoospermic patients without fresh testicular sperm,at the same time to reduce the pain and trauma of repeated testicular biopsy in men,this method to ensure that a small amount of sperm in the freezing-resuscitation process will not be lost,this method is easy to obtain high-quality thawed sperm.

关 键 词：无精症 卵子透明带 睾丸活组织检查 卵胞浆内单精子显微注射 

分 类 号：R715.5[医药卫生—妇产科学]