异丙酚麻醉不同阶段对卵细胞受精和对早期胚胎质量的影响

目的探讨异丙酚静脉麻醉下取卵手术中卵泡抽吸液中异丙酚的浓度变化及各阶段对卵细胞受精和早期胚胎质量的影响.方法 17例实施超促排卵下体外受精-胚胎移植术的妇女预测卵泡至少有15个,按取卵的先后分3组(早、中、晚)分别培养.记录从静脉给异丙酚到每个卵泡取出时间.检测卵泡抽取液中异丙酚的浓度及观察卵细胞的受精率及卵裂率等.结果取出第G一个卵泡的平均时间是200秒,取出卵泡的平均速率是17.6s/ 个.所有患者的最后一个卵泡抽吸液中异丙酚的浓度明显高于第一个卵泡抽吸液中异丙酚的浓度(P<0.01).除未成熟的卵细胞占总卵泡百分比在3组间有明显的区别外,受精率和卵裂率无明显区别.结论随着麻醉的进展,卵泡抽吸液中异丙酚的浓度逐渐增加,但与所给剂量或持续的时间之间无必然的关联.我们不能显示卵泡抽吸液中升高的异丙酚浓度对卵细胞质量的不利影响.

The effect of differental periord''''s propofol anaesthesia on oocyte fertilization and early embryo quality

Objective: Study the change of concentrations of propofol in follicular fluid during oocyte retrieval and the influence of propofol anaesthesia on oocyte fertilization and early embryo quality. Methods:17 women in assisted reproduction procedures expected to have more than 15 oocyte retrieved,first,middle and last oocytes were cultured separately.Time of anasethsia from i.v. injection of propofol was measured,the concentrations of propofol in follicular fluid was detected and the fertilization,cleavage and embryo development were observed. Results: The mean time from i.v. injection to first follicle aspiration was 200 s.The mean time for the aspiration of each additional oocyte was 17.6 s.The concentrations of propofol in follicular fluid from the first to the last follicle significantly increased( P <0.01).There were no significant difference in all groups in fertilization, cleavage and embryo cell number, but the ratio of mature to immature oocytes was an exception. Conclusion: All had a higher concentration of propofol in the last follicular fluid.However , there was no correlation between the absolute concerntrations or the percentage of increase and the dose given to the patients or the time elapsed between the first and the last follicular aspirations.We did not demonstrate a detrimental effect of the rising concentrations of follicular fluid propofol on oocyte quality.