人绒毛膜促性腺激素注射后取卵时间对卵子及胚胎质量的影响

目的探讨人绒毛膜促性腺激素(hCG)注射后不同取卵时间对辅助生殖技术(ART)周期中卵子及胚胎质量的影响。方法回顾性分析2012年8月—2013年6月在我院行体外受精/卵胞浆内单精子注射-胚胎移植术(IVF/ICSI-ET)长长方案治疗的1 500个取卵周期。按注射hCG后取卵时间的不同,分为A组(注射hCG后35.0~35.5 h),B组(注射hCG后35.6~36.0 h)和C组(注射hCG后36.1~36.5 h),比较三组的基本情况、促排卵情况、获卵率、成熟卵率、受精率、卵裂率及优质胚胎率。结果女方年龄、体质量指数、不孕年限、基础激素水平等一般情况比较三组间无统计学差异(P>0.05),促性腺激素(Gn)的使用、hCG日激素水平及hCG日内膜厚度等促排卵情况比较三组间也无统计学差异(P>0.05),三组的获卵率(80.3%、80.4%、81.4%)、2PN胚胎卵裂率(98.3%、98.2%、98.5%)、优质胚胎率(72.2%、72.4%、70.9%)比较差异均无统计学意义(P>0.05)。成熟卵率和正常受精率分别为85.1%、87.4%、87.7%和75.8%、77.3%、80.8%,三组间比较差异均有统计学意义(P均<0.05)。结论 35.0~36.5 h的时间范围内,延迟注射hCG后取卵的时间能够改善卵子成熟率及正常受精率,但对获卵率、卵裂率、优质胚胎率没有影响。

Comparison among hCG-to-oocyte aspiration intervals on quality of ovum and embryo

Objective To determine whether there was any difference in the outcome of in vitro fertilization among different human ehorionic gonadotropin （hCG） priming-to-ooeyte retrieval intervals. Methods A retrospective study was programmed in our center, including 1 500 in vitro fertilization and embryo transfer （IVF-ET） or intracytoplasmic sperm injection （ICSI） cycles from August 2012 to June 2013. Measurements were analyzed according to intervals between hCG injection and oocyte retrieval as follows： GroupA （hCG＋35.0-35.5 h）, GroupB （hCG＋35.6-36.0 h）, and Group C （hCG＋36.1-36.5 h）. Each patient was analyzed for general conditions, the number of oocytes retrieved, maturation ooeyte rate, 2PN rate, cleavage 2PN embryos, and high-quality embryos. Results There were no significantly differences among the oocytes retrieved rates （80.3% , 80.4% , 81.4% ）, cleavage 2PN embryos （98.3%, 98.2%, 98.5% ） and high quality embryos （72.2%, 72.4%, 70.9% ） （P〉0.05）. While maturation oocyte rate （85.1%, 87.4%, 87.7% ） and 2PN rate （75.8%, 77.3%, 80.8% ） were higher when the interval between hCG priming and oocyte retrieval was prolonged （P 〈 0.05 ）. Conclusion Within the range of 35.0 - 36.5 h, the percentage of mature ooeytes can be increased by prolonging the interval between hCG priming and ooeyte retrieval. The prolonged interval may not increase the number of oocytes retrieved, cleavage 2PN embryos, and high quality embryos.