注射HCG后延迟时间取卵对IVF-ET的卵子及胚胎质量的影响研究

目的探讨注射HCG后延迟时间取卵对体外受精-胚胎移植周期卵子及胚胎质量的影响。方法以2010年10月～2012年3月间因不孕症就诊我中心行体外受精-胚胎移植(IVF-ET)或卵胞浆内单精子注射(ICSI)的辅助生育治疗周期为研究对象,以获卵率、受精率、2PN胚胎卵裂率、优质胚胎形成率、临床妊娠率等为观察指标,按照HCG后的不同取卵时间分组,回顾性分析注射HCG后不同取卵时间的IVF结局:对照组C(34.00～35.99 h取卵组,n=41),研究组A(36.00～36.99 h取卵组,n=457),研究组B(37.00～38.00 h取卵组,n=132)。结果 A、B两组获卵率、受精率分别为71.4%(4841/6779)与83.5%(4041/4841)、71.9%(1477/2054)与80.7%(1192/1477),分别与C组比较65.8%(321/488)与80.4%(258/321)],差异均有统计学意义(p<0.05)。A、B两组2PN胚胎卵裂率、优质胚胎形成率分别为98.9%(3970/4041)与48.5%(1927/3970)、98.7%(1177/1192)与45.6%(537/1177),分别与C组比较96.2%(249/258)与45.8%(114/249)],差异均有统计学意义(p<0.05)。A、B两组临床妊娠率分别为40.5%(173/427)、40.3%(50/124),分别与C组比较29.7%(11/37)],差异均有统计学意义(p<0.05)。而A、B两组之间差异无统计学意义。结论注射HCG后适当延迟时间取卵或可提高体外受精-胚胎移植周期的获卵率、受精率及妊娠率。

EFFECTS OF PROLONGED HCG ACTION ON QUALITY OF OOCYTES AND EMBRYO IN PATIENTS UNDERGOING IN VITRO FERTILIZATION AND EMBRYO TRANSFER CYCLES

Objective To evaluate the effects of prolonged HCG action on quality of oocytes and embryo in patients undergoing in vitro fertilization and embryo transfer. Methods A retrospective study was programmed in our centre, including 630 in vitro fertilization and embryo transfer（ IVF -ET）or intracytoplasmic sperm injection（ICSI） cycles from Oct 2010 to June 2012. Measurements were analyzed according to intervals between HCG injection and o- ocyte retrieval as follows： controlled group C （HCG ＋34. 00 -35. 99 h, n =41）, study group A （HCG ＋36. O0 - 36.99 h, n=457） and study group B （HCG ＋37.00 -38.00 h,n = 132）. Each patient was analyzed for oocyte yield, 2PN rate, cleavage 2PN embryos, high quality embryos, clinical pregnancy rate. Results Significantly lower oocyte yield and 2PN rate were observed in group C 65.8% （321/488） and 80.4% （258/321） ] , compared with that of group A 71.4% （4841/6779） and 83.5% （4041/4841）, p 〈 0.05 ] and group B 71.9% （1477/2054） and 80. 7% （1192/1477） ,p 〈0. 05 ]. Significantly lower 2PN embryos, high quality embryos were observed in group C 96. 2% （249/258） and 45.8% （114/249） ], compared with group A 98.9% （3970/4041） and 48.5% （ 1927/ 3970） ,p 〈 0. 05 ] and group B 98.7% （1177/1192） and 45.6% （537/1177）, p 〈 0. 05 ]. At the same time, a lower clinical pregnancy rate was found in group C 29. 7% （11/37） ] when comparing with group A 40.5% （ 173/ 427 ） ] and group B 40. 3 % （50/124） ] . Conclusion Adequate prolonged HCG action before retrieval will increase oocyte yield, 2PN rate and clinical pregnancy rate, but will not benefits more from much longer HCG action.