待孕妇女年龄和获卵数对卵胞浆内单精子注射治疗结局的影响

Effects of Women's Age and Oocyte Number on the Ttreatment Outcome of Intracytoplasmic Sperm Injection

目的：探讨卵胞浆内单精子注射（ICSI）治疗中待孕妇女年龄和获卵数对胚胎质量及临床结局的影响。方法：接受ICSI助孕治疗的520名待孕妇女,（1）根据年龄分为≤25岁组（A组）、26-30岁组（B组）、31-34岁组（C组）和≥35岁组（D组）,（2）根据获卵数分为≤4枚组（Ⅰ组）、5-10枚组（Ⅱ组）、11-15枚组（Ⅲ组）、16-20枚组（Ⅳ组）和≥21枚组（Ⅴ组）;采用ICSI技术受精,比较ICSI治疗周期后不同年龄组间异常受精率、胚胎停育率、优质胚胎率、胚胎冷冻率、种植率及临床妊娠率的变化,比较不同获卵数组间雌雄原核（2PN）卵裂率、优质胚胎率、胚胎种植率、胚胎冷冻率、胚胎停育率及临床妊娠率的改变。结果：（1）A组和B组的异常受精率及胚胎停育率显著低于C组和D组（P〈0.05）,优质胚胎率和胚胎冷冻率按照A、B、C及D组依次降低（P〈0.05）,A组和B组种植率和临床妊娠率高于C组和D组（P〈0.05）;（2）I组的2PN卵裂率、优质胚胎率和胚胎种植率明显低于Ⅱ、Ⅲ、Ⅳ及Ⅴ组（P〈0.05）;胚胎冷冻率按照Ⅰ、Ⅱ、Ⅲ、Ⅳ组及Ⅴ组依次降低（P〈0.05）;I组的胚胎停育率显著高于Ⅱ、Ⅲ、Ⅳ及Ⅴ组（P〈0.05）,而临床妊娠率则明显低于Ⅱ、Ⅲ、Ⅳ及Ⅴ组（P〈0.05）。结论：随着待孕妇女年龄的增长,胚胎质量下降,临床结局较差;获卵数在11~15枚之间的胚胎质量较高、临床结局较好。

Objective： To investigate the effect of women＇s age and the number of retrieved oocytes on embryo quality and clinical outcome after intracytoplasmic sperm injection（ ICSI）. Methods： A retrospective study was carried out to analyze the clinical data of 520 women receiving ICSI.（ 1） According to age,they were divided into less than or equal to 25 years old group（ group A）,26 to 30 years old group（ group B）,31 to 34 years old group（ group C） and more than or equal to 35 years old group（ group D）.（ 2） According to the oocyte number,they were divided into less than or equal to 4（ groupⅠ）,5 to 10（ group Ⅱ）,11 to 15（ group Ⅲ）,16 to 20（ group Ⅳ） and more than or equal to 21（ group V）. After the period ICSI treatment,abnormal fertilization rate,embryo diapause rate,good quality embryo rate,embryo freezing rate,embryo implantation rate and clinical pregnancy rate between different age group were compared while 2PN cleavage rate,good quality embryo rate,embryo implantation rate,embryo freezing rate,embryo diapause rate and clinical pregnancy rate between different oocyte number group were compared. Results：（ 1） Abnormal fertilization rate and embryo diapause rate of group A and group B were lower than those of group C and group D（ P〈0. 05）. Among the four groups,good quality embryo rate and embryo freezing rate showed a decreasing trend from group A to group D（ P〈0. 05）. Embryo implantation rate and clinical pregnancy rate of group A and group B were higher than those of group C and group D（ P〈0. 05）.（ 2） 2PN cleavage rate and good quality embryo rate and embryo implantation rate of group Ⅰ were lower than those of the other groups（ P〈0. 05）. Between the five groups,embryo freezing rate showed a decreasing trend from group Ⅰ toⅤ（ P〈0. 05）. Embryo diapause rate of group Ⅰ was higher than that of the other groups（ P〈0. 05）,while clinical pregnancy rate of group Ⅰ was significantly lower than that of the other groups（ P〈0. 05）. Conclusion： With the increase of pregnant women＇s age,embryo quality is decreased and clinical outcome is poor. When the embryo number is between 11 and 15,embryo quality was high and clinical outcome is good.