IVF周期中含滑面内质网聚集体卵母细胞的形成及其对胚胎发育的影响

Formation of oocyte with smooth endoplasmic reticulum aggregates in IVF cycle and its effect on embryonic development

目的探讨常规体外受精(IVF)中含滑面内质网聚集体(SERa)卵母细胞的形成及其对胚胎发育的影响。方法回顾性分析2014年1月至2017年7月在本院生殖医学科行IVF的313例患者的临床资料,根据受精拆除颗粒细胞后是否可见SERa,分为SERa+周期组和SERa^-周期组,探讨含SERa周期发生的相关因素及其对胚胎发育的影响。结果 313个周期中,至少有一个卵母细胞含SERa的周期(SERa+周期)共有28个,发生率为8.9%;SERa+周期组与SERa^-周期组患者的年龄、不孕年限差异均无统计学意义(P>0.05);而促排卵方案中,SERa+周期组注射HCG日E2水平显著升高(P<0.05),两组的促性腺激素(Gn)总量和使用时间,以及注射HCG日LH和孕激素水平均无统计学差异(P>0.05);与SERa^-周期组相比,SERa+周期组在获卵数上显著增加(P<0.05),而正常受精率及D3优胚率则显著下降(P<0.05)。结论 IVF周期出现SERa可能与患者注射HCG日血清E2水平升高有关,SERa出现会影响胚胎发育。

Objective：To investigate the formation of oocyte with smooth endoplasmic reticulum aggregates（SERa）in IVF cycle and its effect on embryonic development.Methods： The clinical data of 313 patients undergone IVF in the Department of Reproductive Medicine of our hospital from January 2014 to July 2017 were retrospectively analyzed.According to whether or not SERa was found after the granulose cells were removed,the cycles were divided into the SERa＋cycles and the SERa^-cycles to investigate the factors related to the occurrence of the SERa cycle and its influence on the embryonic development.Results：SERa was found in 28 cycle among 313 cycles with a incidence of 8.9%.There were no significant differences in maternal oocytes and duration of infertility between SERa＋cycles and SERacycles（P〉0.05）.There was a significant increase in E2 level on HCG day in SERa＋cycles（P〈0.05）.The total amount and duration of Gn used and LH progesterone levels on HCG day were not significantly different between the two groups（P〉0.05）.Compared with the SERa^-cycles,the number of oocytes retrieved in the SERa＋cycles was significantly increased（P〈0.05）,while the normal fertilization rate and the high quality embryos rate on Day 3 were significantly decreased（P〈0.05）.Conclusions： The presence of SERa was associated with increased E2 level on HCG day.The occurrence of SERa affects embryo development.