激光破膜软件评估卵母细胞受精及妊娠结局的作用研究

The role of laser software in evaluating oocyte fertilization and pregnancy outcome

目的利用激光破膜软件测量中期Ⅱ卵母细胞的形态参数,探寻一种客观评价卵母细胞受精方法,从而提高卵子可利用率和优质胚胎率。方法共78个周期接受了激光破膜仪器测量作为实验组,常规操作共80个周期作为对照组。应用激光破膜软件分别测量卵母细胞直径、透明带厚度、卵周间隙的宽度,用相同脉冲频度在透明带打孔,测量同一个卵母细胞受精前透明带、后打孔的直径,比较受精前、后卵母细胞形态学参数的变化,评估卵母细胞受精状态及胚胎发育的潜能。结果受精后卵母细胞的透明带厚度较受精前卵母细胞变薄[(15.5±0.4)μm、(13.8±0.4)μm,P<0.05];与未受精卵母细胞相比,受精卵母细胞卵周间隙的宽度[(6.5±0.4)μm、(5.2±0.3)μm]缩小(P<0.05),卵子受精后透明带打孔孔径变小(P<0.05);测量组受精率和优质胚胎率高于对照组(P<0.05),但2PN卵裂率、着床率和妊娠率差异无统计学意义(P>0.05)。结论卵母细胞透明带厚度和硬度对预测受精具有一定的临床价值,监测卵母细胞参数并结合常规极体判断能够提高受精率和优质胚胎率。

Objective To measure the morphological parameters of mid-stage II oocytes by using laser software,and to explore an objective method for evaluating oocyte fertilization,so as to improving the availability of eggs and the rate of high-quality embryos.Methods A total of 78 measured cycles served as experimental group,and 80 routine operated cycles were in control group.Laser software was used to measure the diameter of oocyte,the thickness of zona pellucida,the width of perivitelline space,the same pulse frequency was used to punch the zona pellucida.The diameter of the same oocyte zona pellucida before and after fertilization were measured.The changes of oocyte morphological parameters before and after fertilization were compared,and the fertilization status of oocytes and the potential of embryo development were evaluated.Results The zona pellucida of oocytes after fertilization became thinner[(15.5±0.4)μm vs.(13.8±0.4)μm,P<0.05];Compared with the unfertilized oocytes,the perivitelline space the of fertilized oocytes was reduced[(6.5±0.4)μm vs.(5.2±0.3)μm,P<0.05],diameter of laser-drilled openings in zona pellucida becomes smaller after fertilization(P<0.05);The fertilization rate and high-quality embryo rate of the measurement group are higher than the control group(P<0.05),but there was no statistical difference in 2PN cleavage rate,implantation rate and pregnancy rate(P>0.05).Conclusion The thickness and hardness of oocyte zona pellucida have certain clinical value for predicting fertilization,combining with conventional polar body judgment,monitoring oocyte parameters can improve fertilization rate and high-quality embryo rate.