卵母细胞激活技术在辅助生殖技术中的临床应用

Clinical application of oocyte activation in assisted reproductive technology

目的观察辅助激活技术对辅助生殖技术中受精低下或失败患者成熟卵母细胞的激活效果及其胚胎发育情况。方法回顾性分析2014年10月至2016年10月在山西省儿童医院妇幼保健院生殖医学中心助孕治疗、至少有1次ICSI受精失败或受精低下(受精率<30%),再次行ICSI助孕时采用成熟卵母细胞激活处理的12名患者资料。12名患者共收集105枚成熟卵母细胞,全部采用钙离子载体A23187联合6-甲基氨基嘌呤(6-DMAP)进行激活处理,观察卵母细胞激活后的原核形成及胚胎发育情况。结果激活周期的受精率及卵裂率分别为63.81%(67/105)和88.06%(59/67),较既往周期的受精率[23.96%(23/96)]和卵裂率[69.57%(16/23)]均显著升高(P<0.05);激活周期中可移植胚胎及优质胚胎数量较既往周期均显著提高,分别为(3.02±2.51)vs.(1.41±0.58)枚和(1.70±1.36)vs.(0.31±0.52)枚(P<0.05);既往ICSI受精低下或失败的12例患者中,卵母细胞激活处理后5例患者获得临床妊娠。结论辅助激活技术可以改善ICSI受精失败或受精低下患者的受精率及胚胎发育质量。

To observe the effect of assisted activation on the effect of mature oocytes in patients with poor fertilization or failed fertilization,and evaluate the embryonic development.Methods:Oocyte activation technology was adopted for12patients with a history of poor fertilization or failed fertilization after ICSI(fertilization rate<30%)in Reproductive Medicine Center of Shanxi Province Maternal and Child Health Hospital from October2014to October2016.A total of105mature oocytes were collected from12patients and all of them were activated by calcium ionophore A23187combined with6-dimethylaminopurine(6-DMAP).The prokaryotic formation and embryonic development were observed after activation of oocytes.Results:The fertilization rate and cleavage rate of the activation cycle were63.81%(67/105)and88.06%(59/67),which were significantly increased compared with previous cycle[23.96%(23/96)and69.57%(16/23)](P<0.05).The numbers of transplanting embryos[(3.02±2.51)vs.(1.41±0.58)]and high quality embryos[(1.70±1.36)vs.(0.31±0.52)]in the activation cycle were significantly higher than those in the previous cycles(P<0.05).Five patients got clinical pregnancy after oocyte activation in the12patients with poor fertilization or failed fertilization after ICSI.Conclusions:Assisted activation technology can improve fertilization rate and the potential of embryonic development in patients with poor fertilization or failed fertilization.