• 廣西壯族自治區(qū)人口和計劃生育研究中心（南寧，530021）;

【摘要】 目的  觀察提前去除卵丘細胞對胚胎質(zhì)量的影響，進一步探討其臨床應用價值。 方法  將2009年7-9月行體外受精-胚胎移植治療的患者隨機分為兩組，試驗組共137個周期，于授精后5 h去除卵丘細胞；對照組共146個周期，于授精后16～18 h去除卵丘細胞。兩組均于授精后16～18 h觀察受精情況，72 h對胚胎進行評分，選擇1～3枚優(yōu)質(zhì)胚胎進行胚胎移植。分別比較兩組的年齡、不育年限、獲卵數(shù)、受精率、卵裂率、優(yōu)質(zhì)胚胎率、胚胎種植率和臨床妊娠率。 結(jié)果  兩組的優(yōu)質(zhì)胚胎率差異有統(tǒng)計學意義（P lt;0.01）；但年齡、不育年限、獲卵數(shù)、受精率、卵裂率、胚胎種植率和臨床妊娠率比較，差異均無統(tǒng)計學意義（P gt;0.05）。 結(jié)論  體外受精中提前去除卵丘細胞優(yōu)質(zhì)胚胎增加，有助于提高臨床累積妊娠率。
【Abstract】 Objective  To evaluate the effect of denuding the oocyte granulose cells soon after fertilization in vitro (IVF). Methods  A total of 283 IVF cycles in patients from July to September 2009 were divided into a trial group and a control group randomly. The trial group contained 137 cycles, being denuded the oocyte granulose cells only 5 hours after IVF. The controlled group contained 146 cycles, being denuded the oocyte granulose cell and observed the pronuclear 18 hours after IVF. The outcomes of female age, infertile duration, the number of oocyte, fertilization rate,abnormal fertilization rate, good quality embryo rate, and clinical pregnancy rate were measured. Results  There was no difference in any of the outcomes between the two groups except for the high quality embryo rate (P lt;0.01). The clinical pregnancy rate was higher in the trial group without significant differences (P gt;0.05). Conclusions  Denuding the oocyte granulose cells soon after IVF helps to improve the embryo quality and the clinical accumulated pregnancy rate.

引用本文： 孫燕萍,方偉芬,牛向麗,公方強,陳自洪,黃華. 體外受精后提前去除卵丘細胞對臨床結(jié)局的影響. 華西醫(yī)學, 2010, 25(9): 1708-1710. doi: 復制

版權信息： ?四川大學華西醫(yī)院華西期刊社《華西醫(yī)學》版權所有，未經(jīng)授權不得轉(zhuǎn)載、改編

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11. 張寧媛, 孫海翔, 胡婭莉, 等. 短時受精聯(lián)合早期補救性卵細胞胞質(zhì)內(nèi)單精子注射在完全受精失敗周期的臨床應用[J]. 中華男科學雜志, 2009, 15 (6): 538-541.
  1. 1. 羅麗蘭. 不孕與不育[M]. 北京: 人民衛(wèi)生出版社, 1999: 418-426.
  2. 2. Gianaroli L, Magli MC, Ferraretti AP, et al. Reducing the time of sperm oocyte interaction in human in vitro fertilization improves the implantation rate[J]. Hum Reprod, 1996, 11(1): 166-171.
  3. 3. Dirnfeld M, Bider D, Koifman M, et al. Shortened exposure of oocytes to spermatozoa improves in vitro fertilization outcome: a prospective randomized controlled study[J]. Hum Reprod, 1999, 14(10): 2562-2564.
  4. 4. Kattera S, Chen C. Short coincubation of gametes in in vitro fertilization improves implantation and pregnancy rates: a prospective, randomized, controlled study[J]. Fertil Steril, 2003, 80(4): 1017-1021.
  5. 5. Tomas C, Orava M, Tuomivaara L, et al. Low pregnancy rate is achieved in patients treated with intracytoplasma sperm injection due to previous low or failed fertilization in in vitro fertilization[J]. Hum Reprod, 1998, 13(13): 65-70.
  6. 6. 張麗紅, 王克華, 李娟, 等. 縮短受精前卵母細胞培養(yǎng)和精卵共孵育時間對妊娠結(jié)局的影響[J]. 生殖醫(yī)學雜志, 2006, 15(2): 127-129.
  7. 7. Nagy ZP, Rienzi LF, Ubaldi FM, et al. Effect of reduced oocyte aging on the outcome of rescue intracytoplasmic sperm injection[J]. Fertil Steril, 2006, 85(4): 901-906.
  8. 8. 嚴正杰, 蔡令波, 馮婷, 等. 對體外受精失敗后不同授精時間進行補救ICSI的結(jié)局比較[J]. 生殖與避孕, 2009, 29(5): 329-332.
  9. 9. Chen C, Kattera S. Rescue ICSI of oocytes that failed to extrude the second polar body 6 h post insemination in conventional IVF[J]. Hum Reprod, 2003, 18 (10): 2118-2122.
  10. 10. 孫海翔. 早期補救ICSI的安全性和應用價值[J]. 生殖醫(yī)學雜志, 2009, 18(3): 195-197.
  11. 11. 張寧媛, 孫海翔, 胡婭莉, 等. 短時受精聯(lián)合早期補救性卵細胞胞質(zhì)內(nèi)單精子注射在完全受精失敗周期的臨床應用[J]. 中華男科學雜志, 2009, 15 (6): 538-541.