卵母细胞第一极体形态与卵胞浆内单精子显微注射受精率和胚胎质量的关系

Relationship between the first polar body morphology of human oocytes and the outcome with intracytoplasmic sperm injection

目的:了解人卵母细胞第一极体形态与卵胞浆内单精子显微注射(ICSI)后正常受精率、卵裂率和优质胚胎率的关系。方法:选择行ICSI治疗的110个周期中1017枚人卵母细胞。将卵母细胞第一极体分为Ⅰ、Ⅱ、Ⅲ、Ⅳ四种类型,采用3种来源的精子[手淫取精精子、附睾穿刺/睾丸活检(PESA/TESA)取精精子、冷冻精液精子]授精。ICSI操作后,了解各型第一极体卵母细胞受精率、卵裂率和优质胚胎率。结果:手淫取精患者:各型第一极体卵母细胞正常受精率和卵裂率比较,差异有统计学意义(P<0.05),其中Ⅲ、Ⅳ型正常受精率低于Ⅰ和Ⅱ型,Ⅱ型卵裂率低于Ⅰ和Ⅲ型。PESA/TESA取精患者:各型第一极体卵母细胞正常受精率和取卵后第3天优质胚胎率比较,差异有统计学意义(χ2=8.488和6.789,P=0.044和0.034),Ⅰ型正常受精率低于Ⅱ和Ⅲ型,Ⅰ和Ⅲ型第3天优质胚胎率高于Ⅱ型。冷冻精液取精患者各指标比较,差异无统计学意义。结论:排除精子来源对受精的影响,正常受精可能和卵母细胞第一极体形态有关。

Aim：To understand the relationship between the first polar body morphology of human oocytes and fertilization rate,cleavage rate,and embryo quality after intracytoplasmic sperm injection（ICSI）.Methods：A total of 1 017 human oocytes during 110 treatment cycles with ICSI were selected in human reproductive center.According to the Ebner classification methods,oocytes first polar body were allocated into four types.The 1 017 oocytes were allocated into 3 groups according to the sperm retrieval ways：masturbation sperm retrieval,PESA/TESA sperm retrieval,and frozen semen during ICSI.Relationship between the first polar body morphology of human oocytes and fertilization rate,cleavage rate,and high quality embryo rate were analyzed.Results：Masturbation sperm retrieval patients：the normal fertilization rate and the cleavage rate among 4 groups had obvious differences（P0.05）,The normal fertilization in Ⅰ and Ⅱ polar body morphology of oocytes were higher than that in Ⅲ and Ⅳ polar body morphology,and the clearage rate in Ⅰ polar body morphology was lower than that in Ⅱ or Ⅲ polar body.PESA/TESA sperm retrieval patients：the normal fertilization rate and high quality embryo rate after 3 days among Ⅰ,Ⅱ,Ⅲ polar body morphology of oocytes had obvious differences（χ2=8.488 and 6.789,P=0.044 and 0.034）,the normal fertilization rate was lower in Ⅰ polar body morphology than that in Ⅱ,Ⅲ polar body morphology and the high quality embryo rate after 3 days was higher in Ⅰ polar body morphology than that in Ⅱ polar body morphology.Conclusion：Normal fertilization may relate with morphology of the first polar body of human oocytes.