摘要
目的探讨体外受精-胚胎移植(IVF-ET)周期中多原核胚胎形成的相关影响因素及临床结局。方法回顾性分析2015年7月-2016年6月在南方医科大学附属深圳市妇幼保健院生殖中心接受IVF-ET周期治疗的不孕症患者的540个周期,按多原核所占比例分为3组,A组(281个周期):无多原核受精;B组(179个周期):多原核受精率≤20%;C组(80个周期):多原核受精率>20%。结果 A组h CG日≥14 mm卵泡率高于其他两组,各组间差异有统计学意义(P<0.05);A组h CG日血清E2值、获卵数、成熟卵母细胞数、精子优化后浓度、前向运动精子百分率和活动精子百分率均低于其他两组,差异有统计学意义(P<0.05),且随多原核受精率的升高而降低。C组正常受精率、卵裂率、优质胚胎率和可利用胚胎率均低于其他两组,差异有统计学意义(P<0.05);C组胚胎种植率低于A组,差异有统计学意义(P<0.05);临床妊娠率随多原核受精率的升高而降低,但差异无统计学意义(P>0.05)。结论 h CG日≥14 mm卵泡率低、h CG日E2值高、获卵数多、精子优化处理后浓度和活动率高预示着发生多原核受精的可能性大,高比例的多原核受精将降低胚胎质量和胚胎种植率,进而影响临床结局。
Objective To explore the related influencing factors of polypronucleus formation during in vitro fertilization-embryo transfer（IVF-ET） and clinical outcomes.Methods A total of 540 cycles of infertile patients treated by IVF-ET in the center from July 2015 to June 2016 were analyzed retrospectively,then they were divided into three groups according to the proportion of polypronucleus：group A（281 cycles,without polypronucleus fertilization）,group B（179 cycles,polypronucleus fertilization rate≤20%）,and group C（80 cycles,polypronucleus fertilization rate20%）.Results The proportion of follicles with diameter≥14 mm on the day of human chorionic gonadotrophin（h CG） injection in group A was statistically significantly higher than those in the other two groups（P〈0.05）;the level of serum estradiol,the number of retrieved oocytes,the number of mature oocytes,sperm optimized concentration,the percentage of sperm forward movement,and the percentage of motile sperms in group A were statistically significantly lower than those in the other two groups（P 0.05）,which decreased with the increase of polypronucleus formation rate.The rates of normal fertilization,cleavage,high-quality embryo,and available embryos in group C were statistically significantly lower than those in group A and group B（P〈0.05）.Embryo implantation rate in group C was statistically significantly lower than that in group A（P〈0.05）.Clinical pregnancy rate decreased with the increase of polypronucleus formation rate,but there was no statistically significant difference（P〈0.05）.Conclusion Low proportion of follicles with diameter≥14 mm on the day of h CG injection,high level of serum estradiol,more retrieved oocytes,high sperm optimized concentration,and high percentage of motile sperms reveal high possibility of polypronucleus fertilization,high proportion of polypronucleus fertilization will reduce the quality of embryos and embryo implantation rate,then the clinical outcome is affected.
出处
《中国妇幼保健》
CAS
2017年第13期2980-2983,共4页
Maternal and Child Health Care of China
关键词
体外受精
多原核
受精
In vitro fertilization
Polypronucleus
Fertilization
