精卵孵育时间对体外受精的围产儿结局的影响

摘要
图/表
参考文献
相关文章 (2)

全文: PDF (725 KB) HTML (33 KB)
输出: BibTeX | EndNote (RIS)

摘要目的比较精卵孵育时间对体外受精的围产儿结局的影响。方法回顾分析2013年1月—2014年12月在广西壮族自治区妇幼保健院生殖中心行常规体外受精的3 323例患者,共3 368个取卵周期,根据精卵孵育时间分成2组,精卵相互作用时间3~4 h者为孵育时间缩短组,传统受精组为传统受精方式,精卵过夜孵育16~18 h。比较两组的胚胎发育情况、妊娠结局及新生儿健康状况。结果孵育时间缩短组的正常受精率、优胚率、囊胚率及胚胎利用率分别为70.1%、49.7%、46.0%、52.1%,高于传统受精时间组(分别为:68.2%、48.4%、30.3%、50.9%,P＜0.05)。但孵育时间缩短组的临床妊娠率、种植率、活产率虽稍高于传统受精组,但未达到统计学差异,两组单胎和双胎在孕周、出生体重、低出生体重儿和极低出生体重儿发生率、身长、Apgar评分上差异也无统计学意义,两组出生畸形率比较亦无统计学差异(P＞0.05)。结论缩短精卵孵育时间能有效提高胚胎的发育潜能及胚胎的利用效率,但对围产儿未见明显影响。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：精卵孵育, 胚胎质量, 发育潜能, 种植率, 围产儿结局

Abstract：Objective To explore the effect of incubation time for oocytes and sperm in vitro fertilization on the perinatal outcome.Methods 3323 cases received conventional vitro fertilization in the reproductive medicine center of maternal and child health hospital of Guangxi Zhuang autonomous region were collected from January 2013 to December 2014. A total of 3368 oocyte retrieval cyles were allocated into two groups according to the incubation time of oocytes and sperm:the oocytes were incubated with the sperms for 3-4 hours in short-time IVF group(group A) and 16-18 hours in conventional fertilization group(group B).The embryo development, pregnancy outcome and newborn health conditions between the two groups were compared.Results The rates of the normal fertilization rate, o shorten the incubation time (70.1% vs 68.2%), excellent embryo rate (49.7% vs 48.4%), blastocyst rate (46% vs 30.3%) and the utilization rate of embryos (52.1% vs 50.9%) were significantly better than the traditional fertilization time group (P<0.05). The rates of normal fertilization rate, the top embryo rate, blastocyst rate and utilization rate of embryo in group A were all higher than that of group B(70.1% VS 68.2%, 49.7% VS 48.4%, 46.0% VS 30.3%, 52.1% VS 50.9%, respectively, P<0.05).Although a group of indicators in group A were slightly higher than group B, including the clinical pregnancy rate, implantation rate, live birth rate, there were no statistical significance. There were no statistical significance in gestatinal weeks, birth weight, length, Apgar score, rates of low birth weight and very low birth weight (P>0.05).Conclusion Shortening the incubation time for oocytes and sperm could effectively improve the embryonic development potential and the utilization efficiency of embryos, without evident effects on newborns.

Key words： Incubation of Oocytes and sperm Embryo quality Development potency Implantation rate Newborn outcome

收稿日期: 2017-04-21

基金资助:广西自然科学基金面上项目(2013GXNSFAA019258)

通讯作者: 张波(cestbon269@sina.com)

引用本文:

林若芸,冯贵雪,张波,周红,汪彩珠,陈焕华,舒金辉,黄映琴. 精卵孵育时间对体外受精的围产儿结局的影响[J]. 中国生育健康杂志, 2017, 28(5): 431-434.
LIN Ruoyun, FENG Guixue, ZHANG Bo, et al. Effects of incubation timefor oocytes and sperm in vitro fertilization on the perinatal outcome. Chinese Journal of Reproductive Health, 2017, 28(5): 431-434.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2017/V28/I5/431

1 Omu AE,Al-Azemi MK,Kehinde EO,et al.Indications of the mechanisms involved in improved sperm parameters by zinc therapy.Med Print Pract,2008,17:108-116.
2 O WS,Chen H,Chow PH.Male genital tract antioxidant enzymes--their ability to preserve sperm DNA integrity.Mol Cell Endocrinol,2006,250:80-83.
3 Bungum M,Humaidan P,Axmon A,et al.Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome.Hum Reprod,2007,22:174-179.
4 E S,Gardner DK,Schoolcraft WB,et a1.Extent of nuclear DNA damage in ejaculated spermatozoa impacts on blastocyst development after in vitro fertilization.Fertil Steril,2004,82:378-383.
5 Ahmadi A,Ng SC.Fertilizing ability of DNA-damaged spermatozoa.J Exp Zool,1999,284:696-704.
6 Benchaib M,Braun V,Lomage J,et al.Sperm DNA fragmentation decreases the pregnancy rate in an assisted reproductive technique.Hum Reprod,2003,18:1023-1028.
7 张波,冯贵雪,周红,等.降低体外受精-胚胎移植多胎妊娠的策略及效果分析.国际生殖健康/计划生育杂志,2012,31:399-403.
8 方伟芬,冯贵雪,张波,等.精卵孵育时间对胚胎质量的影响.广西医学,2008,30:1333-1334.
9 Kattera S,Chen C.Short coincubation of gametes in in vitro fertilization improves implantation and pregnancy rates:a prospective,randomized,controlled study.Immunobiology,2003,80:1017-1021.
10 Bungum M,Bungum L,Humaidan P.A prospective study,using sibling oocytes,examining the effect of 30 seconds versus 90 minutes gamete co-incubation in IVF.Hum Reprod,2006,21:518-523.
11 Gianaroli L,Fiorentino A,Magli MC et al.Prolonged sperm-oocyte exposure and high sperm concentration affect human embryo viability and pregnancy rate.Hum Reprod,1996,11:2507-2511.
12 Enkhmaa D,Kasai T,Hoshi K.Long-time exposure of mouse embryos to the sperm produces high levels of reactive oxygen species in culture medium and relates to poor embryo development.Reprod Domest Anim,2009,44:634-637.
13 李娜,苗聪秀,向秋,等.短时受精在体外受精的临床应用.华夏医学,2011,24:247-249.
14 屈宗银,王凤英,李玉艳,等.短时受精对体外受精结果的影响.第三军医大学学报,2010,32:1785-1787.
15 徐鸿毅,罗清炳,董毅飞,等.缩短精子孵育时间对体外受精-胚胎移植结局的影响.湖北医药学院学报,2012,31:1-3.
16 Barraud-Lange V,Sifer C,Pocate K,et al.Short gamete co-incubation during in vitro fertilization decreases the fertilization rate and does not improve embryo quality:a prospective auto controlled study.J Assist Reprod Genet,2008,25:305-310.
17 王喜良,周敏,白雪,等.短时受精结合早期补救卵胞浆内单精子注射在IVF-ET治疗中的应用.中国优生与遗传杂志,2011,19:103-104.
18 张娜,张耀恒,张秩,等.长时受精过程中活性氧及精子的DNA损伤对体外受精结局的影响.中国男科学杂志,2013,27:8-12.