取卵日卵泡大小对体外受精胚胎发育早期的影响

The influence of follicle size on oocyte retrieval day on the early embryonic development of in vitro fertilization-embryo transfer

目的：探讨取卵日卵泡大小对体外受精-胚胎移植（ IVF-ET）中卵子成熟及其受精率、卵裂率、第3日胚胎质量及囊胚形成的影响。方法：以2011年8月至2012年8月在山东省枣庄市妇幼保健院生殖中心行IVF-ET的157个周期1665枚卵子为研究对象,将其分为大卵泡组（ A组）、中卵泡组（ B组）和小卵泡组（ C组）。比较IVF-ET过程中各组的卵子成熟度、受精率、卵裂率、胚胎发育质量。结果：与C 组比较,取卵日直径＞15mm的卵泡获得的卵子成熟度、卵子受精率均较高（P＜0.05）；但取卵日卵泡大小对受精后的卵裂无影响（P＞0.05）。大卵泡组和中卵泡组来源卵子D3日胚胎质量显著高于小卵泡组（可用胚率,P＜0.05）。取卵日直径≥12mm的各类卵泡来源卵子D5、D6、D7日可冻囊胚形成率无显著差异（ P＞0.05）。结论：IVF-ET中,获得取卵日直径＞15 mm卵泡的卵子,有利于卵子的成熟、受精,同时D3日胚胎发育质量；部分12~14 mm的卵泡来源的卵子在IVF-ET术中仍具有使用价值。

Objective：To investigate the effects of different size of follicles on oocyte maturation,fertility rate,cleavage rate,embryo quality in the 3rd day and blastocyst formation. Methods：We analysed 1665 oocytes from 157 cycles of IVF-ET in our unit. All of the oocytes were classified into three groups （ the group of large size follicles,the group of middle size folli-cles and the group of small size follicles） according to the diameter size of folliculars where they come from. The oocyte maturation,fertility rate,cleavage rate,embryo quality and blastocyst for-mation of three groups in IVF-ET cycles were analysed. Results：Comparing with the oocytes coming from follicles larger than 15 mm mature better （ P〈0 . 05 ） . The fertility rate of oocytes coming from follicles follicular diameter〉15 mm on the day of oocyte retrieval were much higher （P〈0. 05）,while the follicular diameter had no effect on cleavage rate（P〉0. 05）. The quality of embryo originated from the group of large size follicles and the group of middle size follicles were much better than that of embryo from the group of small size follicles （ P〈0 . 05 ） . There was no difference about the blastocyst formation among the oocyte coming from follicle large than 12 mm （ P〉0 . 05 ） . Conclusion：In the IVF-ET cycles the maturity of the oocyte larger than 15mm was much better,while cleavage rate and embryo quality on 3 day after retrieval were also better,and some oocytes whose diameter is among 12~14mm still have some values.