显微注射受精的卵母细胞质膜穿破特点对受精和卵裂的影响

The influence of the mode of oolemma breakage at intracytoplasmic sperm injection on oocyte survival and embryo development rate

回顾性分析显微注射受精过程中，卵母细胞质膜穿破的不同情形对卵子存活、受精和卵裂结果的影响。根据显微注射过程，卵母细胞胞浆膜穿破的不同情形，将卵母细胞分为３组：Ａ组：显微注射针穿刺卵母细胞膜过程中，注射针直接进入胞浆内，无需回吸胞浆（ｎ＝３０７）；Ｂ组：注射针穿刺到胞浆深部时，轻微回吸少许胞浆，卵膜即穿破（ｎ＝７６９）；Ｃ组：注射针穿刺到胞浆深部时，用力回吸一定量胞浆，卵膜才穿破（ｎ＝４０５）。结果：Ａ组卵母细胞的存活率最低（７２６％），３组卵母细胞的正常受精率未见统计学差异，但卵裂质量则有显著差异，Ｂ组卵裂球质量较好（碎片＜５０％的卵裂球占７７９％）。结论：卵膜穿破的不同情形对卵母细胞的存活和受精卵的卵裂有一定影响，而对卵母细胞的正常受精影响不大。

Objective: The aim of this study was to examine in a prospective and controlled way the influence of the mode of oolemma breakage at intracytoplasmic sperm injection (ICSI) on oocyte survival, fertilization and embryo development rate. Methods: Three different modes of membrane breakage (the reaction of the oolemma to the penetrating injection needle) during injection were noted: type A needle pricking directly into cytoplasma, no suction ( n =307);type B pricking deep into cytoplasme with slight suction ( n =769);type C pricking deep into cytoplasma and with strong suction of certain amount of cytoplasma ( n =405) Results: Significantly low survival rates were noted after membrane breakage in type A(72.6%), There were no significant differences in the normal fertilization rate (66.8%、68.5%、66 2%),but embryos with significantly better quality (<50% fragmentation) were obtained after injection in B (77.9%) than in A(42%)and C(73.5%). Conclusion: The modes of membrane breakage does not influence the normal fertilization rate, but does affect oocyte survival and cleavage of fertilized ova.