短时受精不同脱颗粒细胞方式对体外受精结局的影响

目的探讨体外受精-胚胎移植（IVF-ET）治疗中几种短时受精脱颗粒细胞方式对胚胎质量及临床结局的影响。方法将261个IVF-ET周期根据脱颗粒细胞时间分为：短时受精后18小时脱颗粒细胞组（A组）94个周期、短时受精后5h脱颗粒细胞组（B组）95个周期和短时受精5h后部分（1/3-1/2）脱颗粒细胞组（C组）72个周期。分别比较三组的受精率、多精受精率、卵裂率、优胚率、胚胎利用率、临床妊娠率、种植率和流产率。结果三组的受精率、正常受精率、多精受精率、卵裂率、临床妊娠率和流产率差异无统计学意义（P〉0.05）,A组的优胚率、胚胎利用率和胚胎种植率显著高于B组（P〈0.05）。结论短时受精后即刻剥除部分卵子颗粒细胞观察第二极体,在确保受精的情况下剩余卵母细胞保留自体卵周颗粒细胞共培养,可以提高常规IVF的胚胎质量,从而提高常规IVF总的临床妊娠率和胚胎种植率。

Impact of fertilization in short period and removal of cumulus cells on the result of in vitro fertilization

Objective：To explore impact of some fertilization in short period with removal of cumulus cells to embryo quality and clinical outcome in vitro fertilization-embryo transfer（IVF-ET）.Method：individ 261 cycles into three groups：A（n=94,gamete co-incubating,removing cumulus cells 18 h after insemination）,B（n=95,gamete co-incubating,removing cumulus cells 5h after insemination）,C（n=72,gamete co-incubating,removing cumulus cells in part 5h after insemination）,Fertilization rate,polyspermy rate,cleavage rate,high quality embyo rate,the rate of embyo,the rate of clinical pregnacy,implantation ratio,and abortion ratio were compared respectivily.Result：there was no statistically significant difference in three groups.But which the high quality embyo rate,the rate of embyo,and implantation ratio in A group was high than B group（P〈0.05）. Conclusion：the method of bserve the second polar body in fertilization in short period with removal of cumulus cells improve embyo quality,enhance the clinical pregancy rate and the rate of embyo.