浮游器优选精子方法对体外受精胚胎发育结局的影响

Effect of sperm selection method of swimming trapper on the embryonic development outcome of in vitro fertilization

目的探讨密度梯度离心结合上游法和浮游器上游法优化精子对两种体外受精IVF/ICSI胚胎发育的影响。方法回顾性分析2021年3月~2022年2月在海南省妇女儿童医学中心生殖医学中心行IVF/ICSI治疗周期的病例。分为密度梯度离心结合上游法(IVF周期:n=276;ICSI周期:n=79)和浮游器上游法(IVF周期:n=126;ICSI周期:n=78),比较两组精子优化方法在IVF/ICSI治疗周期中的受精率、卵裂率、优质胚胎率、囊胚形成率及可利用囊胚率等指标之间的差异。结果IVF周期浮游器上游法组的双原核受精率为(72.2±19.9)%显著高于密度梯度离心结合上游法组(68.0±18.0)%,差异有统计学意义(P<0.05)。浮游器上游法组多原核受精率显著低于密度梯度离心结合上游法组(5.3±9.1)%vs(7.4±9.9)%;浮游器上游法组优质囊胚率(62.6±33.0)%显著高于密度梯度离心结合上游法组:(53.2±34.0)%,差异均有统计学意义(P<0.01)。ICSI周期的浮游器上游法组D3优质胚胎率为(38.0±27.7)%,显著高于密度梯度离心结合上游法组(28.2±25.3)%;浮游器上游法组优质囊胚率为(52.6±37.0)%,显著高于密度梯度离心结合上游法组(40.2±38.3)%,差异均有统计学意义(P<0.05)。结论浮游器上游法优化精子后可获得更高的正常受精率和优质胚胎率,降低多原核受精率,减少精子损伤,提高胚胎质量。

Objective To explore the effect of density gradient centrifugation combined with upstream method and floater upstream method on the embryo development of IVF/ICSI in vitro fertilization.Methods A retrospective analysis was performed on patients who underwent IVF/ICSI treatment cycles at the Reproductive Medicine Center of Hainan Women and Children′s Medical Center from March 2021 to February 2022.Divided into density gradient centrifugation combined with upstream method(IVF cycle:n=276;ICSI cycle:n=79)and swimming traper upstream method(IVF cycle:n=126;ICSI cycle:n=78).The differences in the rates of fertilization,cleavage,high-quality embryo,blastocyst formation,and available blastocyst in IVF/ICSI treatment cycles between the two groups of sperm optimization methods were compared.Results In IVF cycles,the rate of double pronuclear fertilization in the swimming traper upstream method group was(72.2±19.9)%,which was significantly higher than that in the density gradient centrifugation combined with upstream method group:(68.0±18.0)%,with significant difference(P<0.05).The rate of multi pronuclear fertilization in the swimming traper upstream method group was significantly lower than that in the density gradient centrifugation combined with upstream method group(5.3±9.1)%vs(7.4±9.9)%;The rate of high-quality blastocysts in the swimming traper upstream method group was(62.6±33.0)%;which was significantly higher than that in the density gradient centrifugation combined with upstream method group:(53.2±34.0)%,with statistically significant difference(P<0.01).In ICSI cycles,the rate of D3 high-quality embryos in the swimming traper upstream method group was(38.0±27.7)%,which was significantly higher than that in the density gradient centrifugation combined with upstream method group:(28.2±25.3)%;The rate of high-quality blastocysts in swimming traper upstream method group(52.6±37.0)%,which was significantly higher than that in the density gradient centrifugation combined with upstream method group:(40.2±38.3)%,with statistically significant difference(P<0.05).Conclusions After optimizing selection sperm by the upstream method of swimming trapper,we can obtain higher normal fertilization rate and high-quality embryo rate,reduce multi pronuclear fertilization rate,reduce sperm damage and consequently improve embryo quality.