摘要
目的探讨体外受精-胚胎移植(IVF-ET)治疗过程中导致异常受精的相关因素。方法回顾性分析1426例体外受精(IVF)周期不孕症患者(IVF组)和449例卵胞浆内单精子注射(ICSI)周期不孕症患者(ICSI组)的临床资料,对患者实施控制性超排卵方案,观察原核(PN)形成情况。比较IVF组和ICSI组基本情况,IVF组和ICSI组胚胎PN形成率,IVF和ICSI周期中不同年龄段及促性腺激素(Gn)用量胚胎PN形成率,IVF和ICSI周期中不同获卵数胚胎PN形成率。结果IVF组1 PN和≥3 PN的形成率高于ICSI组,0 PN和2 PN形成率低于ICSI组,差异均有统计学意义(P<0.05)。ICSI受精后,>35岁的0 PN形成率高于<30岁和30~35岁,差异有统计学意义(P<0.05)。IVF受精后,>15个获卵数的各PN形成率最高,其中1 PN及2 PN的形成率分别为6.09%、75.63%,高于1~5个获卵数的3.13%、53.30%和6~15个获卵数的3.98%、61.79%,差异有统计学意义(P<0.05)。ICSI受精后,1~5个获卵数的0 PN形成率8.45%高于6~15个获卵数的3.92%和>15个获卵数的4.18%,1 PN形成率0.58%低于6~15个获卵数的2.53%和>15个获卵数的2.87%,差异均有统计学意义(P<0.05)。结论患者的年龄、授精方式、Gn用量及获卵数是异常受精的影响因素,在促排过程中根据患者的实际情况及时更改用药量,以降低异常受精胚胎的发生率,避免胚胎浪费,为患者提供更合适的治疗方案。
Objective To investigate the related factors of abnormal fertilization during in vitro fertilization and embryo transfer(IVF-ET).Methods There were 1426 infertile patients who received in vitro fertilization(IVF)taken as the IVF group,and 449 infertile patients who received intracytoplasmic sperm injection(ICSI)as the ICSI group,and all their clinical data was analyzed retrospectively.A controlled ovarian hyperstimulation was performed for patients,and the formation of pronucleus(PN)was observed.Comparison was made on the basic situation and the PN formation rate of embryos of IVF group and ICSI group,and the PN formation rate of embryos at different ages and gonadotropin(Gn)dosage and the PN formation rate of embryos with different number of retrieved oocytes in IVF and ICSI cycles.Results The formation rate of 1 PN and≥3 PN in the IVF group was higher than that of the ICSI group,and the formation rate of 0 PN and 2 PN was lower than that of the ICSI group.All the difference was statistically significant(P<0.05).After ICSI fertilization,the rate of O PN formation in the>35-year-old group was higher than that of the<30-year-old group and 30-35-year-old,and the difference was statistically significant(P<0.05).After IVF fertilization,the PN formation rates of those>15 retrieved oocytes were the highest,of which the formation rates of 1 PN and 2 PN were 6.09%and 75.63%respectively,which were higher than 3.13%and 53.30%of those with 1-5 retrieved oocytes and 3.98%and 61.79%of those with 6-15 retrieved oocytes(P<0.05).After ICSI fertilization,the 0 PN formation rate of those with 1-5 retrieved oocytes was 8.45%,which was higher than 3.92%of those with 6-15 retrieved oocytes and 4.18%of those>15 retrieved oocytes,and the 1 PN formation rate 0.58%was lower than 2.53%of those with 6-15 retrieved oocytes and 2.87%of those>15 retrieved oocytes.All the difference was statistically significant(P<0.05).Conclusion Age,mode of insemination,dosage of Gn and number of eggs harvesting are the influencing factors of abnormal fert
作者
曾伟荣
蔡桂丰
熊永崂
阮永铭
赵琴
ZENG Wei-rong;CAI Gui-feng;XIONG Yong-lao(Reproductive Center,Zhuhai Maternal and Child Health Hospital,Zhuhai 519000,China)
出处
《中国实用医药》
2021年第24期15-18,共4页
China Practical Medicine
基金
广东省珠海市科技计划医疗卫生项目(项目编号:ZH2202200068HJL)。
关键词
体外受精
卵胞浆内单精子注射
未见原核
单原核
多原核
In vitro fertilization and embryo transfer
Intracytoplasmic sperm injection
Non-pronucleus
Monopronuclear
Polypronuclear
