短时受精并即刻脱颗粒细胞在IVF-ET治疗中的应用分析

目的:探讨体外受精-胚胎移植(IVF-ET)周期治疗中短时受精并即刻脱颗粒细胞对胚胎质量的影响及其临床应用价值。方法:将500例IVF-ET周期治疗中的卵子按精卵孵育时间的不同及是否即刻脱颗粒细胞,随机分为短时受精并即刻脱颗粒细胞组(A组,精卵共同孵育4～6 h后随机选取1/2数量卵子脱颗粒细胞)、短时受精并次日晨脱颗粒细胞组(B组,所剩1/2数量卵子,精卵共同孵育4～6 h并加精后18～20 h脱颗粒细胞)和长受精组(C组,精卵孵育过夜)。分别比较三组的受精率、多精受精率、卵裂率、优质胚胎率、妊娠率、胚胎种植率。结果:三组的受精率、多精受精率和卵裂率差异无统计学意义(P>0.05);A、B组的优质胚胎率、临床妊娠率和胚胎种植率显著高于C组(P<0.05)。结论:短时受精并即刻脱颗粒细胞不影响受精率和卵裂率,但可提高优质胚胎率、胚胎种植率及临床妊娠率;短时受精并即刻脱颗粒细胞能观察第二极体是否排出及较准确地判断卵子成熟度,从而及时进行早补救卵胞浆内单精子显微注射(R-ICSI),避免受精失败,保证胚胎种植与子宫内膜发育的同步性。

Analysis on applications of short-term fertilization and immediate degranulation cells in in vitro fertilization and embryo transfer

Objective:To explore the effects of short-term fertilization and immediate degranulation cells in in vitro fertilization and embryo transfer(IVF-ET) cycles and their clinical application values.Methods:A total of 500 ova in IVF-ET cycles were randomly divided into group A(short-term fertilization and immediate degranulation,co-incubation of sperms and ova for 4-6 hours,then half degranulation cells were randomly selected),group B(short-term fertilization and degranulation in the morning on the next day,the residual half ova,co-incubation of sperms and ova for 4-6 hours and insemination,then degranulation after 18-20 hours),and group C(long-term fertilization,co-incubation of sperms and ova overnight) according to different co-incubation times of sperms and ova and immediate degranulation or not.The fertilization rates,the polyspermy rates,the cleavage rates,the good quality embryo rates,the pregnancy rates,the embryo implantation rates in the three groups were compared.Results:There was no statistically significant difference in the fertilization rate,the polyspermy rate,and the cleavage rate among the three groups(P>0.05).the good quality embryo rates,the clinical pregnancy rates,and the embryo implantation rates in group A and group B were statistically significantly higher than those in group C(P<0.05).Conclusion:Short-term fertilization and immediate degranulation cells didn’t affect the fertilization rate and the cleavage rate,but they can improve the good quality embryo rate,the clinical pregnancy rate,and the embryo implantation rate;which can observe the discharge of the second polar body and judge the degree of maturation of oocytes,so rescued ICSI can be performed timely to avoid fertilization failure and ensure the synchrony of embryo implantation and development of endometrium.