血清和卵泡液中抗精子抗体对体外受精——胚胎移植的影响

目的 评价女性抗精子抗体对体外受精－－胚胎移植（ＩＶＦ－ＥＴ）的影响。方法 采用ＥＬＩＳＡ法测定施行ＩＶＦ－ＥＴ的妇女的血清和卵泡液中抗精子抗体（ＡｓＡｂ）。Ａ组：血清ＡｓＡｂ阳性１３例；Ｂ组：血清及卵泡液ＡｓＡｂ均阳性２９例；Ｃ组：ＡｓＡｂ阴性１５８例。分析３组受精率、卵裂率、胚胎发育情况及临床妊娠率和流产率的关系。结果：Ａ、Ｂ组受精率、卵裂率明显低于Ｃ组（Ｐ〈０．０１）。移植日，Ａ、Ｂ组Ⅰ－Ⅱ级胚胎率较Ｃ组低，Ⅳ级胚胎及２原核受精细胞增加（Ｐ〈０．０５）。各组妊娠率及流产率无显著差异（Ｐ〉０．０５）。结论 ＡｓＡｂ对ＩＶＦ和早期胚胎发育有损害，体外培养不能完全清除ＡｓＡｂ对ＩＶＦ－ＥＴ的影响。

Effect of female antisperm antibodies in serum and follicular fluid on in vitro fertilization embryo transfer

Objective To evaluate the effect of female antisperm antibodies（AsAb） on in vitro fertilization-embryo transfer（IVF-ET）. Methods Concentration of AsAb of serum and follicular fluid in women undergoing IVF-ET was measured with ELISA. Group A：13 women with AsAb positive in serum， Group B： 29 women with AsAb positive in serum and follicular fluid， Group C： 158 women with AsAb negative. The IVF rate， cleavage rate， early embryonic development as well as clinical pregnancy and abortion rate were analyzed and compared among the three groups respectively.Results The IVF rate and cleavage rate in group A and B decreased significantly as compared with group C （P＜0.01） . On the day of embryo transfer，Ⅰ—Ⅱgrade embryo rate in group A and B were significantly lower than that in group C.However，gradeⅣand 2PN embryo rates increased significantly as compared with group C （P＜0.05）. There were no significant difference in pregnancy and abortion rates among the three groups （P＞0.05）.Conclusion AsAb may exert a detrimental effect on IVF and early embryonic development， which can not be overcome completely by improving in vitro culture.