【摘要】 目的 觀察提前去除卵丘細(xì)胞對(duì)胚胎質(zhì)量的影響，進(jìn)一步探討其臨床應(yīng)用價(jià)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(jī)分為兩組，試驗(yàn)組共137個(gè)周期，于授精后5 h去除卵丘細(xì)胞；對(duì)照組共146個(gè)周期，于授精后16～18 h去除卵丘細(xì)胞。兩組均于授精后16～18 h觀察受精情況，72 h對(duì)胚胎進(jìn)行評(píng)分，選擇1～3枚優(yōu)質(zhì)胚胎進(jìn)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(jì)學(xué)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(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。 結(jié)論 體外受精中提前去除卵丘細(xì)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(qiáng),陳自洪,黃華. 體外受精后提前去除卵丘細(xì)胞對(duì)臨床結(jié)局的影響. 華西醫(yī)學(xué), 2010, 25(9): 1708-1710. doi: 復(fù)制
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- 1. 羅麗蘭. 不孕與不育[M]. 北京: 人民衛(wèi)生出版社, 1999: 418-426.
- 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. 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. 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. 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. 張麗紅, 王克華, 李娟, 等. 縮短受精前卵母細(xì)胞培養(yǎng)和精卵共孵育時(shí)間對(duì)妊娠結(jié)局的影響[J]. 生殖醫(yī)學(xué)雜志, 2006, 15(2): 127-129.
- 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. 嚴(yán)正杰, 蔡令波, 馮婷, 等. 對(duì)體外受精失敗后不同授精時(shí)間進(jìn)行補(bǔ)救ICSI的結(jié)局比較[J]. 生殖與避孕, 2009, 29(5): 329-332.
- 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. 孫海翔. 早期補(bǔ)救ICSI的安全性和應(yīng)用價(jià)值[J]. 生殖醫(yī)學(xué)雜志, 2009, 18(3): 195-197.
- 11. 張寧媛, 孫海翔, 胡婭莉, 等. 短時(shí)受精聯(lián)合早期補(bǔ)救性卵細(xì)胞胞質(zhì)內(nèi)單精子注射在完全受精失敗周期的臨床應(yīng)用[J]. 中華男科學(xué)雜志, 2009, 15 (6): 538-541.