齿轮状透明带卵母细胞受精失败分析

Analysis of fertilization failure in gear-like zona pellucida oocytes

目的:研究齿轮状透明带卵母细胞的受精、胚胎发育和临床妊娠结局。方法:选取2010年1月至2016年12月在湖北医药学院附属人民医院生殖医学中心就诊且由于齿轮状透明带卵母细胞导致IVF治疗周期中完全受精失败的12例不孕患者和透明带形态正常治疗周期完全受精失败的82例患者为研究对象。将前者12例患者设为实验组,后者82例患者设为对照组。分析比较两组患者年龄、不孕类型、不孕年限、促排卵时间、Gn总用量、HCG日E2和LH水平、获卵数、MII卵数、卵裂率、优胚率、胚胎种植率、临床妊娠率等。结果:实验组患者ICSI受精率稍低于对照组ICSI受精率,其差异无统计学意义;实验组第5天囊胚形成率明显低于对照组第5天囊胚形成率,其差异具有统计学意义;其余各项指标两组差异均无统计学意义。结论:这类齿轮状透明带形态的卵母细胞常规体外受精会导致受精失败,早期识别此类卵母细胞并进行及时的补救ICSI,可以改善临床妊娠结局。

Objective： To study the fertilization, embryonic development and clinical outcome of gearshaped zona pellueida ooeytes. Methods： Twelve infertile patients and zona pellueida morphology were selected from January 2010 to December 2016 at the Reproductive Medicine Center of the People＇s Hospital of Hubei Medical College and due to the gear-shaped zona pellueida ooeytes leading to complete fertilization failure during the IVF treatment cycle. Eighu4wo patients who failed complete fertilization during the normal treatment cycle were included in the study. The former 12 patients were set as the experimental group, and the latter 82 patients were set as the control group. The age of the two groups, the type of infertility, the age of infertility, the time of inducing ovulation, the total dose of Gn, the level of E2 and LH on HCG, the number of eggs obtained, the number of eggs in MII, the rate of cleavage, the rate of blasting, the rate of embryo implantation, Clinical pregnancy rate, etc. Results ： The ICSI fertilization rate of the experimental group was slightly lower than that of the control ICSI, but the difference was not statistically significant. The blastoeyst formation rate of the experimental group was significantly lower than that of the control group on the 5th day. The difference was statistically significant. The significance of the study, the other indicators of the two groups of differences were not statistically significant. Conclusions ： Conventional in vitro fertilization of ooeytes with such gear-like zona pellueida morphology leads to failure of fertilization. Early identification of such ooeytes and timely remediation of ICSI can improve clinical pregnancy outcomes.