体外受精中胚胎污染38例临床分析

目的 探讨体外受精过程中胚胎污染的来源，为胚胎污染的处理和预防提供参考。 方法 回顾性分析2000年1月至2010年6月同济医院生殖中心38例胚胎污染。结果 38例胚胎污染中，引起污染的细菌主要是大肠杆菌（23例，60.5%）和真菌（4例，10.5%）。16例曾行精液细菌培养，其中12例精液与污染胚胎培养出的细菌相同，证实约31.6%（12/38）的污染来自精液；在污染源为精液的12例胚胎污染周期中，11例采用上游法处理精子，1例采用密度梯度法处理精子。38例胚胎污染中，37例为 IVF 周期，1例同时行IVF和卵细胞浆内単精子注射（ICSI），IVF周期有污染，ICSI周期无污染。结论 精液是胚胎污染的主要来源，ICSI、密度梯度法处理精子可能降低胚胎污染风险。

Clinical analysis of 38 cases of microbial contamination of embryo cultures during in vitro fertilization.

Abstract： Objective To identify possible sources and management of microbial contamination in in vitro fertilization-embryo transfer (IVF-ET). Methods Relevant data of 38 cases of microbial contamination of embryo cultures were evaluated retrospectively.Results Identification of the contaminating micro-organisms showed that infections were mainly caused by Escherichia coli (n=23, 60.5%) and Candida species (n=4; 10.5%). In 16 cases of semen samples cultured, 12 cases were caused by the semen sample (n=12, 31.6%). Of 12 cases caused by the semen sample, 11 semen samples were prepared by density gradient centrifugation and 2 semen samples were prepared by the swim-up method. Infections were observed only in IVF culture dishes.Conclusion Semen may be the main sources to contaminate IVF culture system. Applying the ICSI procedure may prevents colonization of the culture dishes by micro-organisms. Semen processing by density gradient centrifugation may decrease the risk of microbial contamination of embryo cultures.