体外受精后异常受精的影响因素分析

目的探讨体外受精后单原核和多原核孕卵生成的影响因素，为降低异常受精率探寻可行的方法。方法应用卡方检验分析927个体外受精周期（608个IVF周期和319个ICSI周期），共计9718个卵细胞资料，研究多原核和单原核孕卵生成率与体外受精方式，女方年龄，超促排卵方案，HCG日血清E2水平和获卵数的关系；结果（1）体外受精中单原核孕卵生成率与体外受精方式、女方年龄、获卵数、HCG日血清E2水平、超促排卵方案均无显著性关系；（2）常规IVF周期中多原核孕卵生成率显著高于ICSI组，但．6-的受精率显著低于后者；当获卵数〉15个和HCG日血清E2〉4000pg／ml时，体外受精周期中多原核孕卵生成率显著升高；（3）ICSI组，随着女方年龄的增高，多原核孕卵生成率显著增高。结论体外受精中异常受精生成的机理和影响因素不尽相同，针对不同不孕人群选择合适的体外受精方式有助于提高正常受精率，降低异常受精率。

Analysis of the factors affecting abnormal fertilization on in vitro fertilization

Objective： To investigate the factors affecting monopronuclear and polypronuclear in in vitro fertilization. Methods： The 6815 fertilized ovum of 9718 oocytes from 608 IVF cycles and 319 ICSI cycles were analyzed by analysis of variance to show the influence of the age of women, the stimulating protocol, serum estradiol level on day of hCG , the number of retrieved oocytes on the incidence of monopronuclear and polypronuclear. Results ： （ 1 ） The age of women, the stimulating protocol, serum estradiol level on day of hCG , the number of retrieved oocytes have no significant influence on the incidence of monopronuclear. （2） In IVF group, the incidence of polypronuclear is higher than that in ICSI group, but total fertility rate was inferior to the latter. And the incidence of polypronuclear is significantly increased when retrieved oocytes are more than 15 or serum estradiol level on day of hCG is more than 〉 4000 pg/ml. （3） In ICSI group, the incidence of polypronuclear is significantly increased when the age of female is older than 30 years old. Conclusion ： The affecting factors and incidence mechanism are different between IVF and ICSI, make sure that every couple of infertility have optimal modality in vitro fertilization will help to decline the incidence of monopronuclear and polypronuclear.