摘要
目的分析卵母细胞MⅡ率与ICSI后受精及胚胎发育的关系。方法选取2015年4月至2017年7月在本中心接受Gn RH激动剂(Gn RH-a)促排卵的ICSI治疗患者792例,获卵数≥5枚且≤30枚。首先分析标准方案人群609例,根据卵母细胞MⅡ率的不同将患者分为A组:MⅡ率>90%(N=220)。B组:90%≥MⅡ率>80%(N=179)。C组:80%≥MⅡ率>70%(N=124)。D组:70%≥MⅡ率>50%(N=66)。E组:50%≥MⅡ率>10%(N=20)。以A组为对照,分析BCDE组随着MⅡ率的逐渐降低ICSI后的受精率、2PN受精率、卵裂率、2PN卵裂率、优胚率、2PN优胚率的变化趋势。再根据上述分析结果,将全部入选人群分为高MⅡ率组和低MⅡ率组,分析比较ICSI后的受精率、2PN受精率、卵裂率、2PN卵裂率、优胚率、2PN优胚率的差异。结果标准方案人群,5组患者基本资料无差异的前提下,随着MⅡ率逐渐降低(从A组到E组),受精率、2PN受精率、卵裂率、2PN卵裂率、优胚率、2PN优胚率均呈现逐步降低的趋势。其中,C组、D组的受精率显著低于对照组A组(P<0.013)。2PN受精率降低幅度不显著(P>0.013),异常受精率没有明显波动。卵裂率以及2PN卵裂率呈现相类似的趋势,D组显著低于A组(P<0.013)。优胚率以及2PN优胚率逐渐降低,D组显著低于A组(P<0.013)。在Gn RH-a促排患者中,根据前述分析结果,以70%的MⅡ率为分界,受精率、2PN受精率、卵裂率、2PN卵裂率、优胚率、2PN优胚率呈显著差异(P<0.05)。结论MⅡ率与ICSI后的受精及胚胎发育结局密切相关,MⅡ率降低,受精率、卵裂率、优胚率均呈现下降趋势。尤其是MⅡ率低于70%,不同方案患者受精及胚胎发育均显著降低。MⅡ率可以作为预测ICSI后受精及胚胎发育结局的一个有效指标。
Objective：To analyze the relationship between metaphaseⅡ（MⅡ）rate of oocytes and the outcomes of fertilization and embryo development after ICSI. Methods：We retrospectively analyzed the information of 792 patients accepted Gn RH agonist（Gn RH-a）down-regulation protocols and ICSI treatment in our center from April 2015 to July 2017,whose oocytes number≥5≤30 and MⅡ rate≥10%.609 patients accepted standard protocol on ovarian stimulation among them were analyzed firstly. According to the MⅡ rate,they were divided into five groups. Group A：MⅡ rate90%（N=220）,Group B：90%≥MⅡ rate80%（N=179）,Group C：80%≥MⅡ rate70%（N=124）,Group D：70%≥MⅡ rate50%（N=66）,Group E：50%≥MⅡ rate10%（N=20）.Compared with group A,fertilization rate,2 PN fertilization rate,cleavage rate,2 PN cleavage rate,top-quality embryo rate,2 PN top-quality embryo rate were evaluated in group B,C,D and E. Then divide the whole included population into high MⅡ rate group and low MⅡ rate group according to the previous analysis and compare the differences of above same outcome indicators. Results：The basic characters of five groups were comparable. While fertilization rate,2 PN fertilization rate,cleavage rate,2 PN cleavage rate,top-quality embryo rate,2 PN top-quality embryo rate gradually went down group by group with MⅡ rate decreased. The fertilization rate of group C and D were significantly lower than group A（P〈0.013）,2 PN fertilization rate was decreased from group A to group E but no significant difference was found（P〉0.013）,the abnormal fertilization rate of all group were nearly stable. Cleavage rate and 2 PN cleavage rate showed similar variation trend,group D was significantly lower than group A. The top-quality embryo rate and 2 PN top-quality embryo rate of group D also significantly lower than group A. Conclusion：The outcome of fertilization and embryo development were significantly related with MⅡ rate. Fertilization rate,cleavage rate,top-quality embryo ra
出处
《中国优生与遗传杂志》
2017年第12期102-105,84,共5页
Chinese Journal of Birth Health & Heredity
基金
深圳市基础研究项目(JCYJ20160427113153295
JCYJ20160427113514229)
