摘要
目的:探讨体外受精(IVF)周期中多原核发生与否,对获卵数较低的患者助孕结局的影响。方法:回顾性分析中山大学附属第三医院生殖医学中心在2015年9月至2020年1月期间实施辅助生殖治疗的情况。共纳入1306个IVF周期,发生多原核受精的患者为A组(388例),无多原核受精的患者为B组(918例),比较两组间的基线资料、实验室指标及累计妊娠率、累计活产率、出生体质量等周期结局。结果:A组的抗缪勒管激素水平(AMH)显著高于B组,而可利用胚胎数显著少于B组,两组间的窦卵泡计数(AFC)、平均获卵数、卵子成熟率、受精率、正常受精率、可利用胚胎率和移植胚胎总数差异均有统计学意义,A组的累计妊娠率小于B组,差异有统计学意义,累计活产率也小于B组,但差异无统计学意义。当可利用胚胎数为1~3枚时,随着可利用胚胎数的增加,累计妊娠率和累计活产率相应上升,而当可利用胚胎数为4~5枚时,累计妊娠率和累计活产率达到平台期。结论:当获卵数低的患者出现多原核受精时,患者胚胎移植的成功率因可利用胚胎数减少而降低,会对周期结局产生影响,只有当可利用胚胎数≥4枚时,才可考虑胚胎移植,以达到较为满意的累计妊娠率和累计活产率。
Objective:To investigate the effect of multiple pronuclei on the outcome of assisted pregnancy in patients with low number of oocytes in in vitro fertilization(IVF)cycle.Methods:The periodic data of assisted reproductive therapy in the Reproductive Medicine Center of the Third Affiliated Hospital of Sun Yat-sen University from September 2015 to January 2020 were analyzed retrospectively.A total of 1306 IVF cycles were included.The patients with multiple pronuclear fertilization were in Group A(388 cases),and the patients without multiple pronuclear fertilization were in Group B(918 cases),baseline data,laboratory indicators,cumulative pregnancy rate,cumulative live birth rate,birth weight and other cycle outcomes were compared between the two groups.Results:The AMH of group A was significantly higher than that of group B,while the number of available embryos was significantly lower than that of group B.There were statistically significant differences between the two groups in AFC,average number of retrieved oocytes,oocyte maturation rate,fertilization rate,normal fertilization rate,available embryos rate and total number of transferred embryos.The cumulative pregnancy rate of group A was lower than that of group B with significant differences,while the cumulative live birth rate was also lower than that of group B without significant differences.When the number of available embryos is 1-3,the cumulative pregnancy rate and cumulative live birth rate will increase with the increase of the number of available embryos.When the number of available embryos is 4-5,the cumulative pregnancy rate and cumulative live birth rate will reach the plateau.Conclusion:When multiple pronuclear fertilization occurs in patients with fewer oocytes,the number of available embryos is reduced,and the chance of embryo transfer is reduced,which will have a certain impact on the cycle outcome.Only when the number of available embryos is over 4 embryo transfer can be considered to achieve a relatively satisfactory cumulative pregnancy rate a
作者
宏苹苹
李涛
欧建平
夏欣一
HONG Pingping;LI Tao;OU Jianping;XIA Xinyi(The First School of Clinical Medicine,Southern Medical University,Guangzhou 510515,Guangdong,China;PLA Research Institute of Clinical Laboratory Medicine,General Hospital of Eastern Theater Command,Nanjing 210002,Jiangsu,China;Reproductive Medicine Center,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,Guangdong,China)
出处
《暨南大学学报（自然科学与医学版）》
CAS
北大核心
2023年第2期186-192,共7页
Journal of Jinan University(Natural Science & Medicine Edition)
基金
江苏省科技厅基金项目(BE2018713)。
关键词
体外受精(IVF)
获卵数低
多原核受精
助孕结局
in vitro fertilization(IVF)
low number of oocytes
multiple pronuclear fertilization
assisted pregnancy outcome
