体外受精-胚胎移植中移植胚胎透明带厚度变量与治疗结果的相关性研究

目的 :观察移植胚胎透明带厚度变量 ( ZPTV)对体外受精 -胚胎移植 ( IVF-ET)治疗结果的影响。方法 :在 2 3 2对夫妇进行 2 51个 IVF-ET治疗周期 ,电脑记录移植胚胎图象 ,应用胚胎测量软件进行透明带厚度的测量 ,计算 ZPTV。结果 :2 51个周期共移植 747个新鲜胚胎 ,获临床妊娠 1 0 9例 ( 43 % )。妊娠周期与非妊娠周期的平均 ZPTV值分别为 1 8.4± 6.0 ,1 6.0± 5.6,差异显著 ( P<0 .0 0 5)。并根据移植胚胎的平均 ZPTV值>2 0 %胚胎数目 0、1、≥ 2个将治疗周期分为 3组 ,其临床妊娠率分别为 2 7%、51 %、55%( P<0 .0 0 5) ,胚胎种植率分别为 1 3 %、2 5%、3 0 % ( P<0 .0 0 1 ) ,均随移植胚胎数增加而显著升高。年龄 <3 5岁组 ,移植周期的多胎妊娠率随平均 ZPTV值 >2 0 %胚胎移植数 ( 0、1、≥ 2 )的增加而升高 ( 2 9%、3 4%、62 % ) ,差异有显著性 ( P<0 .0 5) ;但年龄≥ 3 5岁组 ( 3 3 %、2 0 %、2 9% ) ,无显著差异 ( P<0 .0 5) ,移植胚胎形态等级和各年龄段妇女中移植胚胎平均ZPTV值均无显著差异 ( P>0 .0 5)。结论 :移植胚胎的平均 ZPTV值与胚胎种植率、临床妊娠率和多胎妊娠率密切相关 ,平均 ZPTV是衡量胚胎质量的又一重要指标。     

可降解壳聚糖血管外周支持与静脉移植物早期结构的变化

目的　探讨可降解壳聚糖血管外周支持 (CES)对静脉移植物 (VG)早期结构变化的影响 ,为临床提高VG通畅率提供新的治疗方法。　方法　将兔右颈内静脉端 端吻合于同侧颈总动脉建立静脉移植模型 ,以有无CES干预分为支架组与无支架组 (每组 2 4只兔 )。术后 1、2、4周分别切除移植静脉 ,计算机图像分析系统测量和计算内膜、中膜厚度和面积 ,免疫组织化学法检测增殖细胞核抗原 (PCNA)指数观察平滑肌细胞增殖程度。　结果　CES在术后 2周开始降解。支架组VG ,术后 1～ 2周内膜、中膜的厚度和面积、PCNA指数在术后 1周轻度增加 ,1～ 2周维持稳定 ,术后 2周分别为(2 6 3± 3 7) μm、(2 6 0± 1 9) μm、(0 5 6± 0 0 8)mm2 、(0 34± 0 0 5 )mm2 与 (11 5± 2 1) % ,明显低于无支架组的 (5 6 4± 9 4 ) μm、(47 6± 4 9) μm、(1 17± 0 0 8)mm2 、(1 2 0± 0 4 3)mm2 与 (36 6± 2 9) % (P <0 0 1) ;术后 4周虽然又增加 ,分别为 (31 7± 1 6 ) μm、(31 7± 1 6 ) μm、(0 72± 0 12 )mm2 、(0 4 2± 0 0 6 )mm2 与 (13 4± 1 2 ) % ,但仍低于无支架组的 (76 8± 8 0 ) μm、(5 7 4± 9 5 ) μm、(1 2 7± 0 17)mm2 、(1 2 7± 0 0 9)mm2 与 (16 8± 2 2 ) % (P <0 0 5 )。结论　CES     

左旋精氨酸对大鼠心脏移植物血管病变的抑制作用

目的　研究左旋精氨酸对大鼠心脏移植物血管病变的抑制作用及其机理。方法　采用大鼠异位心脏移植模型。对照组 :移植后不用左旋精氨酸 ;实验组 :移植后按 80 0mg·kg-1·d-1将左旋精氨酸加入饮水中。于移植后 2个月和 3个月检测各组的心脏移植物 ,血管病变评分和血浆一氧化氮含量。结果　移植后 2个月 ,实验组的移植物存活率为 90 .5 % ,显著高于对照组的 6 1.5 % (P <0 .0 5 )。移植后 2个月和 3个月 ,实验组血浆一氧化氮含量均显著高于对照组 ,分别为 ( 10 5 .37± 10 .6 6 ) μmol/Lvs( 6 8.5 4± 6 .83) μmol/L(P <0 .0 5 ) ,和 ( 10 4.5 3± 12 .31) μmol/Lvs ( 6 6 .32± 10 .5 4) μmol/L(P <0 .0 5 ) ;而对照组心脏移植物血管病变评分显著高于实验组 ,分别为 2 .4± 0 .7vs 1.1± 0 .6 (P <0 .0 5 ) ,和 3.0±0 .8vs 1.6± 0 .9(P <0 .0 5 )。实验组心脏移植物的冠状动脉内膜病变轻微 ,内皮和内弹力层基本保持完整 ,平滑肌细胞增殖不明显。结论　补充左旋精氨酸可改善心脏移植物血管病变 ,其机理与一氧化氮合成增加有关。一氧化氮具有保持内皮功能 ,抑制平滑肌细胞增殖的作用。     

肝细胞生长因子对大鼠移植小肠粘膜结构的保护作用

目的　探讨肝细胞生长因子 (HGF)对大鼠移植小肠粘膜结构的保护作用。方法　近交系Wistar (RT1k)大鼠行异位全小肠移植后第 2天开始给予肠外营养至第 10天 ,对照组 (n =10 )行常规TPN支持 ,HGF组 (n =10 )行常规TPN支持的同时加用人胎肝细胞生长因子 15 0 μg/ (kg·d) ,观察移植肠粘膜结构的形态学参数如绒毛高度、绒毛宽度、隐窝深度、粘膜厚度及绒毛表面积的变化 ,以及移植肠上皮细胞超微结构变化及移植肠粘膜蛋白质和DNA含量的改变。结果　移植前两组肠粘膜形态学参数差异无显著性意义 ,行移植及TPN后对照组各参数较移植前明显减小 (P<0 .0 5 ) ;而HGF组各参数与移植前比较变化不明显 (P>0 .0 5 ) ,但明显高于对照组 ,分别是绒毛高度为 ( 2 98.79± 2 2 .3 1) μmvs ( 176.45± 14 .62 ) μm ,P=0 .0 0 1;绒毛宽度为 ( 10 7.46± 12 .3 4) μmvs ( 74.2 0± 16.85 ) μm ,P =0 .0 0 4;隐窝深度为 ( 10 4.5 6± 11.17) μmvs ( 74.45± 8.3 4)μm ,P =0 .0 0 0 5 ;粘膜厚度为 ( 4 0 9.5 3± 3 5 .83 ) μmvs( 2 5 9.3 8± 2 4.65 ) μm ,P =0 .0 0 3 ;绒毛表面积为 ( 0 .10 1± 0 .0 11)mm2 vs ( 0 .0 41± 0 .0 0 5 )mm2 ,P =0 .0 0 1。HGF组蛋白质含量明显高于对照组 (P =0 .0 12 )而与基准值接近     

重组卵泡刺激素与高纯度尿提取卵泡刺激素在辅助生殖的疗效比较

目的　比较重组卵泡刺激素 (rFSH)与高纯度尿提取卵泡刺激素 (uFSH)在促超排卵周期中的有效性和安全性。　方法　 2 0 2例接受体外受精 胚胎移植 (IVF ET)的不育患者 ,随机分为rFSH组 1 0 0例及uFSH组 1 0 2例。两组均采用黄体期长方案促超排卵。卵泡监测、取卵、IVF、ET等均按本中心常规进行。观察两组用药时间、用药剂量、获卵数、妊娠率及重度卵巢过度刺激综合征 (OHSS)发生率等。　结果　rFSH组与uF SH组比较 ,使用FSH天数及安瓿数显著减少 (P <0 .0 5) ,分别为 ( 1 2 .5± 2 .4)及 ( 1 4 .6±1 .7)、( 2 8.7± 7.6)及 ( 3 2 .6± 4.9) ,hCG日直径 >1 0mm的卵泡数、获卵数、优质胚胎率及可冻存胚胎率显著增多 (P <0 .0 5)。临床妊娠率 (分别为 42 %及 3 7.3 % )、胚胎种植率、多胎率、重度OHSS发生率 (分别为 3 %及 2 % )无显著差异 (P >0 .0 5)。　结论　虽然两组种植率及妊娠率无差异 ,但rFSH能更有效地促卵泡生长从而获得更多数量的优质卵与胚胎     

过滤器头皮针的研制与应用

为提高静脉推注用药的安全性 ,研制了一种孔径 3μm的过滤器头皮针 ,经微粒检测及临床应用 ,微粒 数≥10 μm为 8.73± 5 .4 8、≥ 2 5 μm为 0 .6 0± 0 .4 2 ,均低于国家标准 ,与普通头皮针比 ,差异有极显著性意义 (P <0 .0 1) ;静脉炎发生率亦显著低于对照组 (P <0 .0 1)。提示过滤器头皮针能有效阻隔药液中的微粒。     

两种仪器测量角膜厚度的对比观察

目的探讨Orbscan角膜地形图检查系统 (ORB)与角膜内皮测厚仪测量的角膜厚度值之间的差异性。方法分别应用ORB与角膜内皮测厚仪对 17例 (34眼 )病人的中央角膜厚度进行测量 ,对两组测量值进行配对t检验、直线相关和回归分析。结果ORB检测的角膜厚度均值为 (5 17 6 4± 49 4 8) μm ,角膜内皮测厚仪检测的均值为(5 42 4 4± 35 91) μm ,后者显著高于前者 (t=2 37,P <0 0 5 ) ,两者呈显著正相关 (r =0 6 5 8,P <0 0 1)。 结论临床测量角膜厚度时应考虑两种仪器测量值之间的差异性 ,以作出精确判断。     

冻融胚胎复苏状态对移植周期临床结果的影响

目的　观察冻融胚胎复苏状态对移植周期临床结果的影响。　方法　 94对夫妇共进行冻融胚胎移植 (F ET) 99周期。其中自然周期 67个 ,激素替代治疗 3 2周期。冻融 2d或 3d胚胎采用慢速冷冻法和快速解冻法 ,根据卵裂球存活程度分为 3组 :A组为全部移植 1 0 0 %卵裂球存活胚胎 ;B组为全部移植部分卵裂球受损胚胎和C组为混合移植。　结果　 99个周期共融解胚胎 3 3 0个、移植 2 87个 ,融胎存活率 87% ,临床妊娠率 2 3 % ( 2 3 / 99) ,胚胎种植率 1 0 % ( 3 0 / 2 87)。A组临床妊娠率 3 1 % ( 6/ 1 4 )、种植率1 8% ( 1 0 / 3 8) ,B组分别为 6% ( 1 / 1 6)及 2 % ( 1 / 41 ) ,C组分别为 2 3 % ( 1 6/ 69)及 9% ( 1 9/2 0 8) ,A ,B两组比较差异有显著意义 (P <0 .0 5)。进一步分析F ET胚胎中含 4或 8细胞卵裂球完好胚胎数 0 2 ,≥ 3的胚胎种植率 ,分别为 4.5%、1 0 %、1 2 .5%及 43 % ;4组间差别有显著性 (P <0 .0 5)。　结论　移植冻融胚胎卵裂球复苏状态与临床妊娠率密切相关     

子宫内膜厚度和移植胚胎类型对冻融胚胎移植周期临床结局的影响

目的 探讨冻融胚胎移植(FET)周期中子宫内膜厚度和移植胚胎类型对妊娠结局的影响。方法 选取2019年1月至2021年12月在我中心行FET助孕的1 210个周期。患者年龄<40岁，子宫内膜准备方案为人工周期。根据移植胚胎类型分为卵裂期胚胎组(A组，n=536)和囊胚组(B组，n=674)。分别将A组和B组根据移植日内膜厚度分为4个亚组：A1、B1组(内膜厚度<6 mm);A2、B2组(6 mm≤内膜厚度<8 mm);A3、B3组(8 mm≤内膜厚度<12 mm);A4、B4组(内膜≥12 mm)。比较亚组间患者的一般资料以及FET临床结局(临床妊娠率、胚胎着床率、多胎率、流产率及异位妊娠率等)。结果 卵裂期胚胎组(A组)中，A1亚组临床妊娠率显著低于A4亚组(27.50%vs. 56.58%,P<0.05),而4个亚组间胚胎着床率、多胎率、流产率和异位妊娠率均无统计学差异(P>0.05)。囊胚组(B组)中，B1组临床妊娠率显著低于B3、B4亚组(42.11%vs. 65.03%、68.97%,P<0.05),B1亚组异位妊娠率显著高于B3亚组...     

缺血预处理对大鼠移植肝脏保存再灌注损伤的保护及机制探讨

目的探讨缺血预处理 (ischemicpreconditioning ,IP)对大鼠移植肝脏保存再灌注损伤的保护作用及机理。方法采用SD大鼠原位肝移植动物模型 ,12 8只大鼠随机分成A(对照组 )、B(IP组 )、C(腺苷 ,Ado组 )、D(NO合成抑制剂 ,NAME组 )组 ,每组 32只。其中各组的半数用于观察存活率 ,另一半用于移植肝脏再灌注 2h后取血及肝脏检测。结果IP组和Ado组的 1周存活率、血清NO水平及肝组织腺苷含量分别为 88% (7/ 8)和 88% (7/ 8) ,(33 0± 6 1) μmol/l和 (2 9 1± 6 5 ) μmol/l,(7 2± 1 8) μmol/g和 (5 7± 1 3) μmol/g ,均高于对照组的 38% (3/ 8) ,(15 4± 3 0 )mol/L和 (3 6 9±0 5 4 ) μmol/g (P <0 0 5 ) ,血清ALT及TNF含量分别为 (2 87± 82 )IU/L和 (35 7± 93)IU/L ,(1 15± 0 2 3)ng/ml和 (1 14± 0 2 7)ng/ml,均低于对照组的 (5 88± 5 8)IU/L及 (1 5 9± 0 35 )ng/ml(P <0 0 5 ) ,组织的病理学改变也轻于对照组 ;NAME组的 1周存活率、血清NO及ALT含量等分别为 2 5 % (2 / 8)、(13 74± 3 11) μmol/l及 (6 34± 6 5 )IU/L ,与对照组相近 (P >0 0 5 ) ,而肝组织腺苷含量为 (5 5 6± 1 19)μmol/g ,与对照组差异有显著意义 (P <0 0 5 )。 结论IP对大鼠移植肝脏的保存再灌注损伤具有保护     

小鼠卵母细胞透明带膨胀辅助去核方法的研究

目的　探讨新的小鼠卵母细胞透明带膨胀(ZPD)辅助去核法的可靠性。　方法　本实验用 ZPD辅助去核法与其他常用方法对小鼠卵母细胞进行去核操作,比较其去核操作效率。　结果　ZPD辅助去核方法显著提高去核操作后卵母细胞存活率,减少去核操作时间,经卵丘颗粒细胞核移植构建重构胚胎,激活后原核形成率达 62. 8%,经体外培养可发育至 4细胞期。　结论　ZPD辅助去核方法是一种适用于小鼠卵母细胞操作的快速、简单、实用的去核方法。     

A method for mouse oocyte enucleation assisted with zona pellucida dilating

<正>Objective: To study the reliability of a new enucleation method, zona pellucida Dilating (ZPD) assisted enucleation method, for mouse oocyte enucleation. Methods: In ZPD enucleation method, the zona pellucida was dilating with the help of outside pression in enucleation needle after breakthrough by needle tip and the nucleus was aspirated by the needle entering the perivitelline space for enucleation. This method was employed and was compared with three other methods in this experiment. The efficiency of enucleation of mouse oocyte was examed. Result:ZPD assisted enucleation method is better than three others at the survival rate after enucleation and the simplicity of micromanipulation. The rate of forming pronucleus of reconstructed embryo from enucleated oocyte by ZPD methods is as high as 62. 8% and the reconstructed embryo at 4-cell stage was obtained. Conclusion: ZPD assisted method is a highly efficient and simple enucleation method with the advantage of saving manipulating time and it does less damage to the oocyte.     

异常透明带的相关因素分析

目的分析卵母细胞透明带发育不良的相关因素。方法回顾性分析2015年10月至2016年7月于北京大学深圳医院生殖医学科行IVF治疗的患者共569个周期的临床资料,按是否出现透明带发育不良分为2组:出现卵母细胞透明带发育不良为A组,217个周期;卵母细胞正常为B组,352个周期。比较两组基本资料。再按年龄和卵巢功能分组来比较促排卵、获卵与受精情况,分析临床结局。结果 A组与B组相比,年龄[(35.4±5.6)岁vs.(34.4±5.9)岁]、基础FSH[(9.37±5.37)U/L vs.(8.52±4.00)U/L]、AMH[(3.76±5.71)ng/ml vs.(4.68±4.12)ng/ml]均有统计学差异(P<0.05),其中年龄是透明带发育不良的暴露风险因素[OR1.036,95%CI(1.004-1.070)](P<0.05)。再按年龄及卵巢储备功能分组后,≥35~<40岁卵巢储备良好组中的A组与B组相比,Gn天数[(11.7±2.8)d vs.(10.3±3.4)d]、Gn用量[(44.76±16.90)U vs.(34.22±17.44)U]、MII卵数[(6.0±4.1)vs.(9.0±6.1)]均有统计学差异(P<0.05);≥40岁卵巢储备良好组中的A组与B组相比,Gn天数[(11.4±3.9)d vs.(9.4±3.4)d]、Gn用量[(49.24±27.51)U vs.(33.96±18.08)U]、MII卵数[(3.9±2.3)vs.(5.6±4.7)]及优质胚胎率(19.2%vs.40.9%)均有统计学差异(P<0.05)。结论年龄是影响卵母细胞透明带发育的独立暴露危险因素,随着年龄增大(≥35岁时),当患者卵巢储备良好时,Gn用量越多、时间越长,越容易引起透明带发育不良;且透明带发育不良的出现导致该组成熟卵数显著下降,影响促排卵效率;而当年龄≥40岁卵巢储备良好时,透明带发育不良组还会出现优质胚胎率下降。     

Sperm binding capacity of human zona pellucida derived from oocytes obtained from different sources

Summary. The important contributions of sperm-oocyte interaction to infertility diagnostics is well established. Scientists are urged to search for methods to improve the assessment of gamete interaction. Sperm binding and penetration assays have frequented the literature, reporting on various aspects of sperm-oocyte interaction using either microbisected or whole human oocytes during the assay procedure. The objective of the study was to evaluate additional zona pellucida sources which can be used during zona binding studies. Hemizonae were obtained from the following oocytes: 1) experiment 1, prophase I oocytes from post-mortem ovarian tissue from different age groups namely, 7 months, 5 years, 7 years, 12 years and 30 years; 2) experiment 2 used donated immature Prophase I oocytes from the IVF treatment program and 3) experiment 3 evaluated zona binding for hemizonae which were previously used in hemizona assays. Results indicated that, in experiment 1, ovarian age does not have any influence on the zona pellucida's capacity to bind spermatozoa. The mean number of bound sperm among the different age groups did not differ significantly, namely 38.9±17 (7 months), 31.0±27 (5 years), 49.3±21 (7 years), 32.8 ± 18 (12 years) and 39.5 ± 17 (30 years). The pooled mean ±SD binding for all the age groups in experiment 1 was 37.7 ± 7. Likewise, the mean number of sperm bound (experiment 2) to zonae collected from oocytes using different ovulation induction regimes were 31.1±20 (unstimulated), 54.4±12 (HMG/HCG) and 15.3 ± 9 (HMG alone). The pooled binding data for experiment 2 were 33.0 ± 20. Results of experiment 3 indicated metaphase II oocytes with previous exposure to sperm retained its binding capacity indicating that hemizonae can be recycled for at least a second binding experiment. Zonae that had been exposed to sperm and that were subsequently stripped from bound sperm, revealed a mean number of bound sperm after re-insemination that were significantly higher than the prophase I oocytes namely, 115.0 ± 2.8 versus 35.6±12 (P = 0.0001). In conclusion, the data highlights (i) new sources of human oocytes needed for sperm-oocyte interaction studies; (ii) the capability of the human zona pellucida to bind sperm after previous exposure and (iii) the importance of nuclear competence to obtain increased zona pellucida binding.     

The relationship between morphology, motility and zona pellucida binding potential of human spermatozoa

Summary. Prediction of the fertilizing potential of human gametes under in vitro conditions has been a major field of interest of assisted reproductive programmes. However, sperm morphology has been regarded as a predictor of human in vitro fertilization rate. This paper prospectively evaluates the relationships among normal sperm morphology and (1) motion characteristics viz. curvilinear velocity (VCL), straight line velocity (VSL), and linearity (LIN) (n = 37) and (2) spermzona pellucida binding capacity under HZA conditions (n = 144) of two separate groups of infertile couples. Semen was evaluated for sperm concentration, percentage motility, forward progression, and percentage normal morphology (strict criteria). The motility characteristics were measured using a computerized Sperm Motility Quantifier (SMQ). The zona binding potential of sperm was evaluated using the hemizona assay. Firstly, the VCL significantly differred between the P-pattern and both the G (72.9 ± 7 vs. 86.3±16 μm s^?1; P = 0.04) and N patterns (72.9 ± 7 vs. 91.0 ± 15 μm s^?1; P = 0.002). The VSL differed only between the P and N patterns, being 19.7 ± 7 vs. 32.6±15 μm s^?1 (P = 0.02), respectively. No significant differences in LIN were noted between any of the three patterns. The sperm concentration differed significantly between the P and both the G (37.9±35 vs. 80.8 ± 9 × 10⁶ ml^?1; P = 0.03) and the N patterns (37.9 ± 35 vs. 89.7 ± 72 × 10⁶ ml^?1; P = 0.05). Significant differences were observed in the percentage motility between the P and both the G (38.0 ± 21% vs. 43.7 ±9%; P = 0.03) and the N patterns (38.0 ± 21% vs. 52.1±8%; P = 0.04). In the second study, the hemizona indices (HZI) differed significantly between the P and both the G (29.3 ± 26% vs. 57.6 ± 62%; P = 0.01) and the N patterns (29.3 ± 26% vs. 102.4 ± 80%; P < 0.001). The G and N patterns also differed significantly in their HZI (57.6 ± 62% vs. 102.4 ± 80%; P = 0.005). Sperm concentration differed between the P and both the G (32.8 ± 29 vs. 76.1±54 × 10⁶ ml^?1; P < 0.001) and the N patterns (32.8 ± 29 vs. 95.44 ± 61 × 10⁶ ml^?1; P < 0.001). The percentage motility differs significantly between the P pattern and both the G (41.2± 17% vs. 50.9±11%; P = 0.002) and the N patterns (41.2±17% vs. 53.4±11%; P = 0.001). Sperm morphology seems to be indicative of important functional characteristics of spermatozoa, for example motility and zona pellucida binding.     

The hemizona assay (HZA) as an experimental model to evaluate the inhibition of sperm binding to the murine zona pellucida by isolated zona pellucida protein

Compelling evidence has demonstrated that zona binding represents gamete recognition by sperm binding with high affinity and specificity to complex glycoproteins of the zona pellucida. In the present study we evaluated the hemizona assay (HZA) in the investigation of the interaction of mouse spermatozoa with unfertilized murine oocytes and hemizonae after exposure to solubilized murine zonae pellucidae proteins. The zonae pellucidae were isolated from ovarian tissue following described mincing techniques. The sperm binding characteristics of murine spermatozoa were studied by using SDS-PAGE isolated ZP2 (+/- 120 Kd) and ZP3 (+/- 83 Kd) components of the zona pellucida. Sperm receptor activity was examined in a competitive gamete binding fashion using the HZA as an indicator of sperm/zona interaction. The results illustrated that isolated, solubilized ZP2 and ZP3 glycoprotein moieties of the zona pellucida inhibited sperm binding to hemizonae and oocytes when compared to controls, and that the HZA can be utilized as an internally controlled homologous bioassay to evaluate the effects of zona pellucida proteins on tight binding of spermatozoa to the zona pellucida.     

短时受精与“搭桥受精”

目前体外受精一胚胎移植（in vitro fertilization and embryo transfer,IVF—ET）已经成为治疗不育症最为有效的方法之一。常规的IVF是将配子在体外自然配对完成受精,受精过程与体内存在很大差异,在体内能够达到受精部位与卵子接触的精子是有限的（数十条～数百条不等）,这些精子在经过女性生殖器到达卵子周围的过程经历了严格的自然选择,     

Correlation between sperm penetration into the human zona pellucida and in vitro fertilization rates

Summary.  Sperm penetration into the zona pellucida of unfertilized oocytes, and its correlation with in vitro fertilization rates of the sibling oocytes, were assessed. This was performed in order to evaluate the prediction rate of the sperm penetration test into the zona pellucida. Unfertilized oocytes ( n =1872) from 371 cycles were pipetted through a microcapillary, and the remaining sperm cells penetrating the zona pellucida were counted. The mean (±SD) number of spermatozoa that penetrated the zona pellucida of unfertilized oocytes was 12.9±16.37. A significant correlation was found between the fertilization rate and the mean number of spermatozoa that penetrated into the zona pellucida of the unfertilized sibling oocytes (r = 0.48; P < 0.001), or the percent of unpenetrated zonae pellucidae in a cohort (r= —0.43; P < 0.001). However, a distinct variation in the number of spermatozoa that penetrated into the zona pellucida was detected. A step-wise regression analysis proved the number of spermatozoa penetrating the zona pellucida to be more predictive for fertilization rates than the variable of percent of unpenetrated zonae pellucidae. The results imply that although there is interdependence between penetration into the zona pellucida and fertilization rate, the predictive value of sperm penetration test for prognosis and future management after the first in vitro fertilization attempt, is limited.     

胚胎透明带显微操作与单卵双胎妊娠

目的探讨体外受精-胚胎移植(IVF-ET)后单卵双胎妊娠与胚胎透明带显微操作的关系。方法回顾分析在我院行IVF-ET后获得临床妊娠的1,099个周期,比较行胚胎透明带显微操作(ZPM)和未经显微操作的两组患者单卵双胎(MZT)妊娠的发生率。结果IVF-ET后临床妊娠1,099周期中,MZT16周期,发生率为1.46%,占多胎的7.6%。显微操作组临床妊娠462周期,MZT6周期,发生率为1.30%;无显微操作组临床妊娠637周期,MZT10周期,发生率为1.60%,两组无显著差异(P>0.05)。结论单卵双胎妊娠与胚胎透明带显微操作之间无密切联系,积极控制IVF-ET的多胎妊娠可能是减少单卵双胎的有效途径。