降低聚乙烯吡咯烷酮浓度对卵胞浆内单精子显微注射效果的影响

Effect of a decreased polyvinylpyrrolidone concentration on the outcome of intracytoplasmic sperm injection

目的:探讨卵胞浆内单精子注射(ICSI)操作中,降低聚乙烯吡咯烷酮(PVP)浓度对ICSI效果的影响。方法:将132例160个周期接受ICSI治疗的患者所获1549个MⅡ卵随机1∶1分配,分别采用在含7%和3.5%PVP(对有A、B级活动精子的周期)或者在3.5%和不含PVP(对仅有C、D级活动精子的周期)操作液中制动的精子行ICSI,比较ICSI效果。结果:PVP浓度为3.5%时,ICSI卵的受精率和卵裂率分别为80.12%和96.78%,与PVP浓度为7%时的受精率(79.84%)和卵裂率(96.89%)比较差异无显著性(P>0.05),但采用3.5%PVP制动精子行ICSI获得的优质胚胎率达77.76%,高于7%PVP制动时的71.43%,差异有显著性(P<0.05)。在不含PVP操作液中制动精子后行ICSI,卵子的受精率、卵裂率及优质胚胎率均与在3.5%PVP制动精子行ICSI差异无显著性(P>0.05)。结论:对于活动力良好的精子,降低精子制动液的PVP浓度至3.5%,可提高ICSI的优质胚胎率。精子活动力差时,进一步降低PVP浓度对ICSI效果无明显影响。

Objective To explore whether a decrease of polyvinylpyrrolidone （PVP） concentration will affect the outcome of ICSI. Methods 1 549 M II oocytes harvested from 160 cycles of 132 infertile women were randomized in a 1：1 ratio to receive ICSI with the spermatozoa that had been immobilized either in 7% or 3.5% of PVP solution （for the cycles with good sperm mobility） or in 3.5% of PVP or PVP-free solution （for the cycles with poor sperm mobility）. The impacts of PVP at different concentrations on ICSI were compared. Results The rate of good-quality embryo differed significantly as the PVP concentration was 3.5% or 7% （77.76% vs 71.43%, P〈 0.05） whereas the fertilization rate and cleavage rate did not （80.12% vs 79.84% and 96.78% vs 96.89%, respectively, P 〉 0.05）. There were no significant differences in the rates of fertilization, cleavage, and good-quality embryo under the conditions of 3.5% of PVP or PVP-free solution （P 〉 0.05）. Conclusions For spermatozoa with good mobility, to decrease the PVP concentration to 3.5% may enhance the rate of good quality-embryo. A further decline in the PVP concentration, however, dose not affect the outcome of ICSI when spermatozoa have poor mobility.