培养箱换水对体外受精-胚胎移植治疗结局及新生儿的影响

目的探讨培养箱换水间隔时间对体外受精-胚胎移植（IVF-ET）治疗结局及新生儿的影响。方法回顾分析广西壮族自治区妇幼保健院生殖中心2008年1月至2008年11月行IVF-ET335个治疗周期的相关资料,依据培养箱换水间隔时间分3组：间隔1～7d、间隔8～14d和间隔15～21d,比较各组间正常受精率、卵裂率、优胚率、种植率、临床妊娠率及新生儿情况。结果 （1）各组间患者年龄（男、女方）差异不显著（P〉0.05）;换水间隔15d～21d组正常受精率显著低于其它两组（61.71%vs68.05%,61.71%vs72.63%;P〈0.05）,而多精受精率显著高于其它两组（17.26%vs12.34%,17.26%vs11.78%;P〈0.05）,卵裂率、周期冷冻率、种植率、妊娠率三组间差异无统计学意义（P〉0.05）;（2）335个移植周期共分娩140个婴儿,其中单胎分娩86例,双胎分娩27例,出生婴儿未见先天异常,3组间宫外孕率、活胎分娩率、孕周、出生体重差异无统计学意义（P〉0.05）,而流产率随换水间隔时间的延长有上升趋势。结论 （1）培养箱换水间隔时间在2周内有利于正常受精及胚胎的后续发育,延长可能使多精受精率及流产率增高;（2）培养箱换水间隔时间在1d～21d并未对IVF-ET的助孕后的新生儿健康情况产生明显影响。

Effects of interval time of water changed in the incubator on pregnancy outcomes and live births

Objective：To ascertain the effects of interval time of water changed in the incubator on IVF-ET pregnancy outcomes and live births.Methods：The study were divided into three groups according to the interval time of water changed：interval time of 1-7d group,8 ～ 14d group and 15 ～ 21d group.The fertilization rate,cleavage rate,the rate of freezing embryo cycles,implantation rate,pregnancy rate and live births of these three groups were compared.Results：（1） There were not significant difference in patient＇s age among the three groups （P 0.05）.The fertilization rate of 15 ～ 21d group was significant lower than the other two groups （61.71% vs 68.05%,61.71% vs 72.63% ;P 0.05）,while the polysperm rate was significal higher （17.26% vs 12.34%,17.26% vs 11.78% ;P 0.05）.Among the three groups,no difference was observed in cleavage rate,the rate of freezing embryo cycles,implantation rate,pregnancy rate and live births （P 0.05）.（2） Of 140 babies from the three groups,86 cases was single infant and 27 cases were twins.Babies with congenital birth defect were not observed,and gestational age,average birth weight of the three groups were also no significant difference.However,the abortion rate of 15 ～ 21d group was slightly high.Conclusions：（1） Interval time of water changed in the incubator within 2 weeks benefits to the normal fertilization of oocytes and further development of embryos.while interval time 2 weeks may result in the increased ploysperm and miscarriage rates.（2） Effects of interval time of water changed from 1 to 21 days on the pregnancy outcomes and live births were not observated.