论文部分内容阅读
目的探讨授精后5 h对可能受精失败的卵子行补救性卵胞浆内单精子显微注射(ICSI)的可行性。方法授精后3、4、5 h分别观察卵子是否排出第二极体。若已经排出第二极体,则认为卵子已经被激活,是受精的征象。如果患者在授精后5 h观察少于65%的卵子排出第二极体,则剩余的只有第一极体的卵子接受补救性ICSI。1 050例接受体外受精-胚胎移植(IVF-ET)的患者,按照有无补救性ICSI将患者分为2组:Ⅰ组:部分接受补救性ICSI,本组又按照有无补救性ICSI将卵子分为两部分:补救性ICSI部分及IVF部分;Ⅱ组:未接受补救性ICSI。201例接受ICSI治疗的患者作为对照组。结果①Ⅰ组患者卵子在授精后3、4、5 h第二极体排出率均低于Ⅱ组(P<0.05),Ⅰ组患者原发不孕的比例、不明原因性不孕的比例高于Ⅱ组(P<0.05);②Ⅰ组、Ⅱ组、对照组,受精率、多精受精率、临床妊娠率、种植率均无显著性差异(P>0.05),但Ⅰ组补救性ICSI部分卵子优胚率低于Ⅱ组和对照组(P<0.05)。结论 IVF中精卵共培养3 h是可行的;授精后5 h第二极体的排出可作为卵子激活的征象;授精后5 h行补救性ICSI可获得可观的临床结局,且不会增加多精受精率;低受精率可能更易出现在原因不明性不孕及原发不孕患者。
Objective To investigate the feasibility of intracytoplasmic sperm injection (ICSI) on fertilized eggs at 5 h after insemination. Method 3, 4, 5 h after fertilization were observed whether the egg excreted second polar body. If you have discharged the second polar body, then that the egg has been activated, is a sign of fertilization. If the patient observed less than 65% of the eggs exiting the second polar body 5 h after insemination, only the first polar body’s egg received a salvaged ICSI. In 1050 patients undergoing in vitro fertilization-embryo transfer (IVF-ET), patients were divided into two groups according to whether ICSI was salvaged or not: group I: part received salvage ICSI, and group received salvage Divided into two parts: remedial ICSI part and IVF part; Group II: did not receive remedial ICSI. 201 patients undergoing ICSI treatment served as controls. Results ① The excretion rate of the second polar body in the eggs of Ⅰ group was lower than that of Ⅱ group at 3, 4 and 5 h after insemination (P0.05). The proportion of primary infertility in group Ⅰ was higher than that of unexplained infertility Ⅱ group (P <0.05). ② There was no significant difference in fertilization rate, fertilization rate, clinical pregnancy rate and implantation rate betweenⅠ, Ⅱgroup and control group (P> 0.05) The excellent embryo rate was lower than that of group Ⅱ and control (P <0.05). Conclusion The co-culture of spermatozoa in IVF for 3 h is feasible. The excretion of the second polar body at 5 h after insemination can be used as an indicator of egg activation. Reproductive ICSI 5 h after fertilization can achieve considerable clinical outcomes without increasing High precision; low fertility may be more likely to appear in unexplained infertility and primary infertility patients.