受精早期观察第二极体对胚胎发育及IVF-ET结局的影响

目的:探讨体外受精-胚胎移植(IVF-ET)治疗中早期观察第二极体判断受精的方法对胚胎发育及IVF-ET结局的影响。方法:回顾性研究郑州大学人民医院2010年全年行IVF长方案治疗的患者606例,根据病史判断受精障碍风险将其分为两组。A组:受精后4 h拆除颗粒细胞判断早期受精。B组:受精后17～18 h观察受精。分别比较两组年龄、获卵数、卵子成熟率、正常受精率、可利用胚胎率(可利用胚胎数/2PN卵裂数)、胚胎种植率、临床妊娠率及早期流产率。结果:两组可利用胚胎率差异具有统计学意义(P<0.05),其它各项统计指标均未见明显差异(P>0.05)。结论:受精障碍高风险患者在4 h拆除颗粒细胞观察第二极体有降低可利用胚胎率的风险,不建议所有IVF患者使用。

The effect of observing the second polar body to judge the early fertilization on embryo development and IVF-ET outcomes

Objective ： To explore the effect of observing the second polar body after short insemina- tion to judge the early fertilization in vitro fertilization （IVF） on embryos development and IVF-ET outcomes. Methods： Retrospective analyze 606 patients with long-term IVF treatment in the Peo- ple＇ s Hospital of Zhengzhou University. The patients were divided into two groups according to fer- tilization risk. Group A ： dismantled cumulus cells only 4 hours after short insemination. Group B ： dismantled cumulus cells 17 to 18 hours after short insemination. The patients＇ age, the number of retrieved oocytes, oocytes maturation rate, fertilization and cleavage rate, available embryo rate, implantation rate, clinical pregnancy rate, and spontaneous abortion rate were compared between the two groups. Results： The available embryos rate in group A was significantly lower than group B （P 〈 0.05）. There was no significant difference in the other outcomes between the two groups （P 〉 0.05 ）. Conclusion： For patients with high-risk fertilization barriers, observing the second polar body by dismantling cumulus cells in 4 hours after short insemination may decreasing the a- vailable embryo rate. So it is not recommended for all IVF patients.