IVF-ET中低受精率事件发生相关因素分析

Analysis of factors associated with low fertilization rate in IVF-ET

目的分析在体外受精中影响低受精率事件发生的相关因素。方法回顾性分析2014年1月1日至9月30日在本生殖中心行体外受精胚胎移植(IVF-ET)辅助生殖技术治疗的1387个周期,以受精率(受精率=受精卵数/总卵数)30%为界,受精率<30%为A组(151个周期),受精率≥30%为B组(1236个周期),比较两组患者的年龄、体重指数、不孕年限、原发/继发不孕、基础卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、雄激素(T)、孕激素(P)、促性腺激素(Gn)用药总量、Gn总天数,注射绒毛膜促性腺激素(HCG)日的P、E2、LH、FSH水平,取卵术后第二天E2水平,手术适应证,手术日平均卵泡数、平均获卵数、成熟卵数。二分类变量Logistic回归分析P<0.05的变量与低受精率事件发生的关系。结果两组间年龄、体重指数、基础激素及注射HCG日的激素(FSH、LH、E2、P、T)、Gn总量、Gn总天数、平均获卵数差异均无统计学意义(P>0.05)。两组不孕年限、原发/继发不孕、手术适应证、平均卵泡数、成熟卵数差异有统计学意义(P<0.05)。二分类变量Logistic回归分析显示卵泡数(OR=1.050)、成熟卵数(OR=0.890)、适应证(OR=1.719)与IVF-ET低受精率事件的发生有密切关系(P<0.05)。结论在IVF-ET中低受精率事件的发生与适应证中男性因素关系密切,其次是卵子发育成熟同步性。

Objective To analyze factors associated with the occurrence of low fertilization rate of in vitro fertilization.Methods A retrospective analysis was carried on 1387 cycles that received in vitro fertilization and embryo transfer（ IVFET） combined with reproductive technology in the reproductive center from January to September,2014. Fertilization rate（ fertilization rate=number of fertilized eggs / total egg number） = 30% was regarded as the dividing point,those with fertilization rate〈30% were selected as group A（ 151 cycles）,while those with fertilization rate≥30% as group B（ 1236 cycles）.Then,ages,body mass index（ BMI）,duration of infertility,primary / secondary infertility,basal follicle stimulating hormone（ FSH）,luteinizing hormone（ LH）,estradiol（ E2）,testosterone（ T）,progesterone（ P）,total dose of gonadotropin（ Gn）,total Gn days of the two groups were compared.In addition,P,LH,E2,and FSH levels in the day of human chorionic gonadotropin（ HCG） injection,E2 level in the second day after vaginal egg retrieval,surgical indications,average number of follicles in operation day,numbers of average retrieved oocytes and mature eggs were also compared.Binary Logistic regression analysis was performed in the relation of P〈0.05 variable between occurrence of low fertilized rates.Results Difference of the ages,BMI,basic hormone and hormone（ FSH,LH,E2,P,T） in the day of HCG injection,total number of Gn,total Gn days and numbers of average retrieved oocytes was not statistically significant（ P〉 0. 05）. However,difference of duration of infertility,primary /secondary infertility,surgical indications,average number of follicles and mature eggs was statistically significant（ P 〈 0. 05）.Binary Logistic regression analysis showed that number of follicles（ OR = 1.050）,mature eggs（ OR = 0.890） and surgical indications（ OR = 1.719） were closely related to occurrence of low fertilized rates in IVF-ET（ P〈0.05）.Conclusion Occurrence of low fertilization rate in IVF-ET is closely related to male factors in the indications,and it is then followed by synchronism of oocyte development and maturation.