两种活动精子分离法的体外受精结局比较

目的:评价Percoll密度梯度法和上游法两种活动精子分离方法在体外受精-胚胎移植(IVF-ET)中的效果。对象和方法:以本中心1999年6月～2001年1月完成的362个IVF-ET治疗周期为研究对象,回顾性地比较了两种活动精子分离方法的受精率、卵裂率、胚胎发育状况和临床妊娠结局。结果:Percoll法和上游法两组比较,受精率分别为71.8％和71.2％,卵裂率88.4％和89.2％,差异均不显著(P>0.05)。取卵后d2,两组胚胎的细胞数分别为2.7±1.3个和3.0±1.0个,差异不显著(P>0.05);两组<20％碎片的优良胚胎率分别为77.6％和65.9％,差异具有统计学意义(P<0.01)。两组临床妊娠率分别为43.7％和36.6％,妊娠周期的活婴出生率分别为70.3％和60.7％,均具有显著性差异(P<0.01)。结论:在IVF-ET治疗不育与不孕中,Percoll法分离的活动精子临床妊娠结局优于上游法。

Comparison between the In Vitro Fertilization Outcome of Two Motile Sperm Separation Methods

Objective: To evaluate the efficiency of percoll density gracdient and swim-up methods for motile sperm isolation from fresh semen samples in in vitro fertilization and embryo transfer(IVF-ET) program. Methods-:The fertilization rate, cleavage rate, embryo developing status and clinical pregnancy outcome of 362 IVF cycles were studied retrospectively. The cycles were divided into two groups with respect to the motile sperm isolation method. Results:There was no significant difference in fertilization rate and cleavage rate between Percoll and swim-up group. Although two groups showing no difference in cell number in embryos, the percentage of embryos with <20% debris(77. 6%) in Percoll group was remarkably higher than that in swim-up group (65. 9%). Percoll group had significantly higher clinical pregnancy rate and baby birth rate (43. 7% and 70. 3%) than swim-up group (36. 6% and 60. 7%) (P<0. 01). Conclusion: The efficiency of Percoll density gradient in motile sperm separation is superior to swim-up in IVF-ET program.