ICSI 周期卵子成熟度对胚胎发育与临床结局的影响

摘要

Objectives:To investigate the influence of oocyte maturation on fertilization,embryo develop-ment and clinical outcomes in intracytoplasmic sperm injection (ICSI)cycles.Methods:33 patients with immature oocyte (MI oocytes or GV oocytes)accounted for more than half of the total in fresh cycle of ICSI cycles,from March 201 2 to December 201 3,were selected as group A.1 38 patients,of whom the number of immature oocyte was less than 20% of the number of retrieved oocytes of ICSI cycles,from September 201 2 to December 201 2,were selected as group B.Fertilization rate,naomal fertilization rate,multinuclear rate,high quality embryos rate,clini-cal pregnancy rate and embryo implantation rate of the two groups were compared.Results:From group A,261 oo-cytes were obtained;the number of mature oocytes was 1 1 8;the fertilization rate was 80.51 %;normal fertilization rate was 72.88%;multinuclear rate was 6.78%;high quality embryos rate was 47.37%;clinical pregnancy rate was 30.30% and embryo implantation rate was 1 9.30%.From group B in,1 330 oocytes were obtained;the num-ber of mature oocyte was 1 1 46;the fertilization rate was 89.97%;normal fertilization rate was 86.39%;multinu-clear rate was 1 .1 3%;high quality embryos rate was 61 .64%;clinical pregnancy rate was 59.42% and embryo implantation rate was 40.88%.The level of fertilization rate,normal fertilization,high quality embryos rate,clini-cal pregnancy rate and embryo implantation rate in group A were obviously higher than those of group B,while the level of multinuclear rate in group A was lower.Conclusion:The overabundance of immature oocyte in ICSI cycles will decrease the embryo utility rate and affect the pregnancy outcome.%目的：研究卵胞浆内单精子注射（ICSI）周期中卵子成熟度对受精、胚胎发育以及临床结局的影响。方法：收集我院从2012年3月至2013年12月，新鲜周期中未成熟卵子（MⅠ或 GV）占获卵数50％及以上的 ICSI 周期为 A 组（n ＝33）；2012年9月至12月，新鲜周期中未成熟卵子小于获卵数的20％为 ICSI周期为 B 组（n ＝138）。比较两组胚胎的受精率、正常受精率、多核率、优质胚胎率、临床妊娠率和种植率。结果：A 组（n ＝33）获卵261枚，成熟卵子118枚；其中受精率80.51％，正常受精率72.88％，多核率6.78％，优质胚胎率47.37％，妊娠率30.30％，种植率19.30％；B 组（n ＝138）获卵1330枚，成熟卵子1146枚，其中受精率89.97％，正常受精率86.39％，多核率1.13％，优质胚胎率61.64％，妊娠率59.42％，种植率40.88％。A 组受精率、正常受精率、临床妊娠率、种植率均显著低于 B 组（P ＜0.05），而多核率显著高于 B组（P ＜0.05）。结论：ICSI 周期中，未成熟卵子比例过高可能影响胚胎的发育潜能及临床结局。