ICSI周期卵子成熟度对胚胎发育与临床结局的影响

The influence of oocyte maturation on embryo development and clinical outcomes in intracytoplasmicsperm injection cycles

目的:研究卵胞浆内单精子注射(ICSI)周期中卵子成熟度对受精、胚胎发育以及临床结局的影响。方法:收集我院从2012年3月至2013年12月,新鲜周期中未成熟卵子(MⅠ或GV)占获卵数50%及以上的ICSI周期为A组(n=33);2012年9月至12月,新鲜周期中未成熟卵子小于获卵数的20%为ICSI周期为B组(n=138)。比较两组胚胎的受精率、正常受精率、多核率、优质胚胎率、临床妊娠率和种植率。结果:A组(n=33)获卵261枚,成熟卵子118枚;其中受精率80.51%,正常受精率72.88%,多核率6.78%,优质胚胎率47.37%,妊娠率30.30%,种植率19.30%;B组(n=138)获卵1330枚,成熟卵子1146枚,其中受精率89.97%,正常受精率86.39%,多核率1.13%,优质胚胎率61.64%,妊娠率59.42%,种植率40.88%。A组受精率、正常受精率、临床妊娠率、种植率均显著低于B组(P<0.05),而多核率显著高于B组(P<0.05)。结论:ICSI周期中,未成熟卵子比例过高可能影响胚胎的发育潜能及临床结局。

Objectives：To investigate the influence of oocyte maturation on fertilization,embryo develop-ment and clinical outcomes in intracytoplasmic sperm injection （ICSI）cycles.Methods：33 patients with immature oocyte （MI oocytes or GV oocytes）accounted for more than half of the total in fresh cycle of ICSI cycles,from March 201 2 to December 201 3,were selected as group A.1 38 patients,of whom the number of immature oocyte was less than 20% of the number of retrieved oocytes of ICSI cycles,from September 201 2 to December 201 2,were selected as group B.Fertilization rate,naomal fertilization rate,multinuclear rate,high quality embryos rate,clini-cal pregnancy rate and embryo implantation rate of the two groups were compared.Results：From group A,261 oo-cytes were obtained;the number of mature oocytes was 1 1 8;the fertilization rate was 80.51 %;normal fertilization rate was 72.88%;multinuclear rate was 6.78%;high quality embryos rate was 47.37%;clinical pregnancy rate was 30.30% and embryo implantation rate was 1 9.30%.From group B in,1 330 oocytes were obtained;the num-ber of mature oocyte was 1 1 46;the fertilization rate was 89.97%;normal fertilization rate was 86.39%;multinu-clear rate was 1 .1 3%;high quality embryos rate was 61 .64%;clinical pregnancy rate was 59.42% and embryo implantation rate was 40.88%.The level of fertilization rate,normal fertilization,high quality embryos rate,clini-cal pregnancy rate and embryo implantation rate in group A were obviously higher than those of group B,while the level of multinuclear rate in group A was lower.Conclusion：The overabundance of immature oocyte in ICSI cycles will decrease the embryo utility rate and affect the pregnancy outcome.