改良直接上游法在体外受精中的应用

Application of Modified Direct Swim-up Technique in IVF

目的:探讨改良直接上游法在常规体外受精(IVF)中的应用价值。方法:487个拟行常规IVF周期中,获卵数均不少于8个。将同一来源卵随机分成实验组和对照组,实验组采取改良直接上游法处理精液,对照组则采用常规上游法处理。比较两组受精及胚胎发育情况,检测两组受精后3小时氧化损伤相关的脂质过氧化水平。结果:实验组精液与对照组相比,精液密度显著降低(22.7±12.6vs28.3±17.8,P<0.01),但活率差异无统计学意义(82.3±13.1vs80.9±12.5,P>0.05)。两组受精率、早补救发生比率、卵裂率、优质胚胎率比较,差异均无统计学意义(73.96%vs71.82%,6.16%vs6.16%,98.92%vs98.63%,56.67%vs57.21%,P>0.05),两组种植率、临床妊娠率、流产率比较,差异也无统计学意义(32.49%vs30.44%,9.38%vs10.83%,P>0.05)。实验组与对照组丙二醛(MDA)水平比较差异有统计学意义(12.23±3.24vs18.51±3.55,P<0.05)。实验组也未增加污染几率。结论:改良直接上游法用于常规IVF周期,是一种简单、有效的精液处理方法。

Objective：To study the application of modified direct swim-up technique in In vitro fertilization （IVF）.Methods：In 487 cycles which planned to receive conventional IVF, the enrolled cycle′s recovery oocytes were more than 8, and then the oocytes were randomly and equally divided into two groups. The standard swim-up technique was used in control group, whereas the modified swim-up technique was used in study group. The condition of fertilization and embryo development were compared in two groups. The lipid peroxidation （LPO） level which related to oxidative damage was detected 3 hours after fertilization in two groups.Results：The sperm concentration decreased significantly（22.7±12.6 vs 28.3±17.8 in study group,P0.01）, but sperm motility showed no significant difference in two groups （82.3±13.1 vs 80.9±12.5,P0.05）. There were no significant difference between study group and control group in fertilization rate, occurrence of early rescue ICSI, cleavage rate, good embryo rate, implantation rate, and abortion rate（73.96% vs 71.82%, 6.16% vs 6.16%, 98.92% vs 98.63%, 56.67% vs 57.21%, 32.49% vs 30.44%, 9.38% vs 10.83%, P0.05 ）. Malondialdehyde （MDA） level in study group was significant lower than that in control group（12.23±3.24 vs 18.51±3.55, P0.05）. The direct swim-up technique did not increase the occurrence of contamination.Conclusions：The modified direct swim-up technique is a simple, effective sperm preparation protocol in routine IVF cycles.