体外短时受精周期中第二极体排出率与精子顶体酶活性关系的探讨

Study on the relationship betteen the sperm acrosin activity and secend poler body extroed rate in Short-Time in vitro fertilazition cycles

目的探讨精子顶体酶活性与体外短时受精周期中第二极体排出时间及排出率之间的关系。方法检测行体外短时受精周期的患者精子顶体酶活性,依据顶体酶活性分成3组：A组〉48.2μIU/106个精子,共130个周期;B组30~48.5μIU/106个精子,共72个周期;C组〈30μIU/106个精子,共34个周期,行体外短时受精后4h对卵丘卵母细胞复合体脱颗粒细胞处理,分别于授精后4 h、6 h观察各组两极体排出率,并对第二极体排出率〈30%的周期行早期补救ICSI,统计3组间第二极体排出率及受精率的差异;结果 A组、B组、C组授精后4h第二极体排出率分别为61%、36.1%和11.8%,各组间差异显著（P〈0.05）;授精后6h A组、B组第二极体排出率分别为79.9%和70%,均显著高于C组的20%（P〈0.05）,但A组、B组两组间差异无统计学意义（P〉0.05）。结论精子顶体酶活性越高体外受精周期中第二极体排出的越早,且第二极体排出率也越高;当精子顶体酶活性〈30μIU/106个精子时,建议行胞质内单精子注射（ICSI）治疗。

Objective： To explore the relationship betteen sperm acrosome enzyme activity and the second polar body elutiont in the short-term in vitro fertilization cycles the relationship between the discharge rate. Methods： Detect the sperm acrosome enzyme activity in short-time in vitro fertilization cycles, on the basis of sperm acrosin activity value, cycles were divided into three groups： group A〉48.2μIU/106 sperm, a total of 130 cycles; group B, sperm acrosin activity value30~48μIU/106 sperm, a total of 72 cycles; Group C〈30μIU/106 sperm, a total of 34 cycles, in short-time in vitro fertilization cycles, after fertilization 4hours every oocytes degranulation cell, respectively 4hours, 6hours after fertilization to observe the polar body extroed rate, and if the second polar body eduction rate〈30%, the cycles were treated with rescue ICSI, statistics the second polar body eduction rate and fertilization rate between the 3 groups of difference; Results： In group A, group B, and group C, after fertilization 4hours the second polar body eduction rate are 61%, 36.1% and 61% respectively, the significant difference between groups （P〈0.05） ; 6 h after fertilization in group A and group B second polar body eduction rate were 79.9% and 70% respectively, 20% were significantly higher than that of group C （P〈0.05） , but in group A and group B there was no statistically significant difference between the two groups （P〉0.05） . Conclusion： The sperm acrosome enzyme activity is higher in vitro fertilization cycle, the earlier of the second polar body extroed and the second polar body extroed rate is higher; When the sperm acrosome enzyme activity〈30μIU/106 sperm, suggested carry out the intracytoplasmic sperm injection （ICSI） treatment.