摘要
目的研究体外受精(IVF)时卵丘卵母细胞复合物(cumulus-oocyte complex,COC)上的卵丘颗粒细胞密度对胚胎学结局的影响。方法回顾性分析710个IVF周期,其中卵丘颗粒细胞部分切除周期(研究组)355个及未处理对照周期355个。研究通过比较两组中患者的受精率、卵裂率、优质胚胎率、卵子利用率、临床妊娠率和活产率等多种指标来探讨IVF治疗时卵丘颗粒细胞对胚胎学和移植结局的影响;随后又按照授精皿中的卵子数将患者分为低密度(1~5个)、中密度(6~10个)和高密度(11~15个)3组,通过与对照组患者比较,进一步明确不同COC授精密度情况下颗粒细胞密度对受精和胚胎发育的影响。结果研究组患者的受精率、正常受精率、有效成囊率和卵子利用率均显著高于对照组(P<0.01),而其异常受精率则显著低于对照组(P<0.01)。低、中及高不同授精密度下,当授精密度≤5个卵子时,研究组和对照组的受精率、正常受精率、异常受精率、有效成囊率和卵子利用率等比较,差异均无统计学意义(P>0.05);当授精密度>5个时,研究组的正常受精率、有效成囊率和卵子利用率均显著高于对照组(P<0.05),异常受精率均显著低于对照组(P<0.05)。两组的临床妊娠率、种植率、活产率等比较,差异均无统计学意义(P>0.05)。结论体外授精时,通过切除COC上的卵丘颗粒细胞以降低其密度,能够改善患者IVF治疗时的胚胎学结局。
Objective To explore the effect of the density of cumulus granulocytes on cumulus-oocyte complex(COC)on embryological outcome during IVF.MethodsThe data of 710 IVF cycles were collected retrospectively,including 355 cycles of partial excision of granular cells(study group)and 355 untreated control cycles.In this study,the impact of the density of cumulus granulosa cells on the embryology and transplantation outcomes was evaluated by comparing fertility rate,cleavage rate,good-quality embryo rate,oocyte utilization rate,clinical pregnancy rate and live birth rate between the two groups.In addition,the patients were divided into three groups according to the number of oocytes in the insemination dishes:low density(1-5),medium density(6-10)and high density(11-15).Compared with the control group,the influence of granular cell density on fertilization and embryo development under different insemination densities was further clarified.By comparing with the patients in the control group,we can further clarify the effect of granular cell density on fertilization and embryo development under different COC precisions.ResultsThe fertilization rate,normal fertilization rate,effective blastocyst formation rate and oocyte utilization rate of patients in the study group were significantly higher than those of the control group(P<001),while abnormal fertilization rate was significantly lower than that of the control group(P<0.01).Under different insemination densities(low,medium and high),when the insemination density was less than or equal to 5,there were no significantly deferences of fertilization rate,normal fertilization rate,abnormal fertilization rate,effective blastocyst formation rate and oocyte utilization rate between the study group and control group(P>0.05).When the insemination density was more than 5,the normal fertilization rate,effective blastocyst formation rate and oocyte utilization rate in study group were significantly higher than those of control group(P<005),while the abnormal fertilization rate was
作者
董竞
吴铃
赵激浪
欧阳杰
凡永
吕祁峰
李孟惠
李斌
Dong Jing;Wu Ling;Zhao Jilang(Department of Assisted Reproduction,Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)
出处
《医学研究杂志》
2020年第11期44-48,37,共6页
Journal of Medical Research
基金
国家自然科学基金资助项目(81971448)。
