低氧培养环境对高龄患者体外受精-胚胎移植结局的影响

目的：探讨低氧（5% O2）培养环境对高龄（≥38岁）患者体外受精-胚胎移植（IVF-ET）临床结局的影响。方法：回顾性分析2015年9月1日-2017年6月1日在广东省韶关市妇幼保健计划生育服务中心生殖医学中心采用常规长方案或拮抗剂方案行IVF治疗并于受精后第3天移植的高龄患者（≥38岁）的283个周期，按其培养环境不同分为低氧组（5% O2，共120个周期）和常氧组（20% O2，共163个周期），比较2组间的正常受精率、卵裂率、可用胚胎率、优质胚胎率、临床妊娠率、种植率及早期流产率等。结果：2组的正常受精率、卵裂率、可用胚胎率、生化妊娠率、临床妊娠率、种植率、早期流产率及活产率比较，差异均无统计学意义（均P＞0.05），但低氧组的优质胚胎率显著高于常氧组（P＜0.05）。结论：低氧培养环境可有效提高高龄患者优质胚胎率，但并不能改善高龄患者的IVF-ET结局。

Effects of Lowered Oxygen Concentration in Embryo Culture on the Outcomes of In Vitro Fertilization-Embryo Transfer for Elderly Women

Objective：To evaluate the effects of the lowered oxygen concentration (5% oxygen) in incubator during embryo culture on the outcomes of in vitro fertilization-embryo transfer (IVF-ET) for elderly women. Methods: The women aged ≥38 years who underwent IVF and fresh embryo transfer in our center from September 1, 2015 to June 1, 2017 were retrospectively analyzed. A total of 283 cycles were assigned into two groups according to the oxygen concentration in the incubator: the 5% oxygen concentration group (n=120) and the 20% oxygen concentration group (n=163). The normal fertilization rate, cleavage rate, available embryo rate, good quality embryo rate, clinical pregnancy rate, implantation rate and early abortion rate were compared between the two groups. Results: There were no significant differences in the normal fertilization rate, cleavage rate, available embryo rate, biochemical pregnancy rate, clinical pregnancy rate, implantation rate, early abortion rate and live birth rate between the two groups (all P＞0.05)，while the good quality embryo rate in the 5% oxygen concentration group was significantly higher than that in the 20% oxygen concentration group (P＜0.05). Conclusions: The lowered incubator oxygen concentration for the embryos of elderly women could obtain the higher rate of good quality embryo，but the effects on clinical pregnancy rate and implantation rate were not obvious.