两种不同培养体系对卵母细胞体外受精及胚胎体外发育的影响

Effect of two types of in-vitro culture systems on the development rate of human embryos

目的 挑选出一种较为理想的体外受精(IVF)培养体系。方法 90例(91个周期)接受IVF/单精子胞浆内注射(ICSI)技术治疗的患者,卵母细胞的IVF及胚胎的体外培养分别采用GⅢ体系(A组, 51周期, )和Quinn体系(B组,40周期)。结果 A组和B组分别获得683枚和652枚卵母细胞,IVF后,受精率分别为63 .25% ( 432 /683 )及66 41%(433 /652),无显著性差异(P>0. 05)。体外培养24h后,A组414枚受精卵发生卵裂,卵裂率为95. 83% ( 414 /432 );B组397枚受精卵发生卵裂,卵裂率为91 69% (397 /433) ,无显著性差异(P>0 .05)。继续培养,行第3天胚胎移植,A、B两组分别获得优质胚胎220及140枚(53. 14%和35. 26% )。最终,A组共有26例获得临床妊娠,B组15例获得临床妊娠,妊娠率为50. 98%和37. 5%,两者之间有显著性差异(P<0 .05)。另外,B组中受精率、卵裂率、优质胚胎率及临床妊娠率方面,IVF周期与ICSI周期之间无显著性差异(P>0. 05),而A组中优质胚胎率及临床妊娠率方面,有显著性差异(48. 97%和63 .11%, 45 .71%和56 25%,P<0 05),受精率和卵裂率方面两周期之间无显著性差异(P>0. 05 )。结论 Quinn系列似乎有助于卵母细胞的体外受精,而GⅢ体系更有利于胚胎的早期发育及后期的着床方面。

Objective To investigate an ideal culture system suitable for in-vitro culture of IVF. Methods Total of 90 patients from 91 cycles were performed the treatment of IVF or ICSI, and their eggs fertilized and embryos were placed into GⅢ medium (group A, 51 cycles) and Quinns medium(group B, 40 cycles) for culture in vitro respectively. Results In group A (51 cycles, 683 oocytes), after fertilization and culture in vitro and embryo transfer,the rates of fertilization, cleavage, top-quality embryos and clinical pregnancy were 63.25%,95.83%,53.14% and 50.98%, respectively L. In group B (40 cycles, 652 oocytes),the rates of fertilization, cleavage, top-quality embryos and clinical pregnancy were 66.41%,91.69%,35.26% and 37.5%, respectively. Fertilization rate in group B was higher than that in group A, however for cleavage rate, the result was just oppsite, and there was no significant difference between the two groups ( P >0.05). Furthermore, top-quality embryo rate and clinical rate in group A were higher compared with that in group B, and differences were not significant between them ( P <0.05). Conclusion Quinns medium is much more effective in the improvement of fertilization rate of oocytes, while the result is just opposite of the early development rates of embryos and implantation rates. Moreover, for post-fertilization oocytes placed into GⅢ medium, it is more advantageous to obtain a high success rate of tube baby by using fertilization way of ICSI compared with IVF.