摘要
目的探讨常规体外受精(in vitro fertilization,IVF)周期中不同比例多原核受精对胚胎发育参数及临床妊娠结局的影响。方法回顾性分析2020年1月至12月在深圳恒生医院生殖医学科行体外受精与胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)治疗的不孕不育患者。纳入治疗后获卵数>5枚的638个周期,根据多原核受精比例,将638个周期分为3组:无多原核组、低比例多原核组(≤10%)和高比例多原核组(>10%),比较3组之间胚胎发育参数及临床妊娠结局。统计学方法采用单因素方差分析、t检验、χ^(2)检验。结果低比例多原核组女方患者的平均年龄低于无多原核组和高比例多原核组[(33±4)、(34±5)、(34±5)岁,F=4.358,P<0.05]。无多原核组、低比例多原核组和高比例多原核组的抗米勒管激素水平分别为[(3.8±2.5)、(5.1±2.9)、(3.8±3.0)μg/L,F=10.614,P<0.001],平均获卵数分别为[(10.6±5.1)、(17.4±6.5)、(11.4±6.4)枚,F=65.357,P<0.001],低比例多原核组均高于其他2组(P<0.05)。高比例多原核组的优质胚胎率高于无多原核组[44.2%(546/1235)、41.2%(977/2371),χ^(2)=1.942,P<0.05)。高比例多原核组和低比例多原核组中的可利用囊胚[64.1%(366/571)、64.8%(529/816)]和优质囊胚[(42.4%(242/571)、40.6%(331/816)]高于无多原核组[59.8%(642/1073)、33.8%(363/1073)],差异均有统计学意义(χ^(2)=3.579、3.854、5.982、5.421,P值均<0.05)。高比例多原核组的临床妊娠率明显低于无多原核组和低比例多原核组[65.3%(49/75)、70.3%(104/148)、70.6%(24/34),χ^(2)=1.435、0.962,P值均<0.05]。低比例多原核组的胚胎种植率高于无多原核组和高比例多原核组[56.4%(31/55)、47.8%(131/274)、47.4%(63/133),χ^(2)=1.273、1.945,P值均<0.05]。结论在IVF周期中存在低比例(≤10%)多原核受精,能获得较好的临床妊娠率和胚胎种植率。
Objective To investigate effects of low frequency poly-pronuclear on embryo development parameters and clinical pregnancy outcome of patients with in vitro fertilization(IVF). Method From January 1 to December 31, 2020, the infertility patients who underwent in vitro insemination and embryo transfer(IVF-ET) in the Department of Reproductive Medicine, Shenzhen Hengsheng Hospital were retrospectively analyzed. A total of 638 cycles with more than 5 eggs obtained were included.All patients were divided into three groups according to the ratio of poly-pronuclear zygotes: normal fertilization group, low frequency poly-pronuclear zygotes group(≤10%) and high frequency polypronuclear zygotes group(>10%), the embryo development parameters and clinical pregnancy outcomes were compared among the three groups. One-way analysis of variance(ANOVA), t-test and χ^(2)-test were applied as statistical approaches. Result The female average age of low frequency poly-pronuclear zygotes group was lower than that in normal fertilization group and high frequency poly-pronuclear zygotes group [(33±4),(34±5),(34±5) years, F=4.358, P<0.05]. Low frequency poly-pronuclear zygotes group was higher than the other groups in Anti-millerian hormone levels [(3.8±2.5),(5.1±2.9),(3.8±3.0) μg/L, F=10.614, P<0.001] and mean number of eggs retrieved [(10.6±5.1),(17.4±6.5),(11.4±6.4), F=65.357, P<0.001]. High frequency poly-pronuclear zygotes group was higher than normal fertilization group in high quality embryo rate [44.2%(546/1 235) vs 41.2%(977/2 371), χ^(2)=1.942, P<0.05]. High frequency poly-pronuclear zygotes group and low frequency poly-pronuclear zygotes group were higher than normal fertilization group in available blastocyst [64.1%(366/571), 64.8(529/816), 59.8%(642/1 073)] and high quality blastocysts [(42.4%(242/571), 40.6%(331/816), 33.8%(363/1 073)], which was statistically significant(χ^(2)=3.579, 3.854, 5.982, 5.421, all P<0.05). Low frequency poly-pronuclear zygotes group were higher than normal fertilization group and
作者
朱元昌
袁琳
谭芳
马壮鸿
邓伟芬
Zhu Yuanchang;Yuan Lin;Tan Fang;Ma Zhuanghong;Deng Weifen(Department of Reproductive Medicine,Shenzhen Hengsheng Hospital,Guangdong,Shenzhen 518034,China)
出处
《发育医学电子杂志》
2022年第5期346-352,共7页
Journal of Developmental Medicine (Electronic Version)
基金
国家自然科学基金(82060281)
广东省医学科研基金(A2022359)。
关键词
体外受精
多原核受精
优胚率
临床妊娠率
种植率
In vitro fertilization
Poly-pronuclear
Top embryo rate
Clinical pregnancy rate
Implantation rate
