In conventional in vitro fertilization（IVF）.since sperm metabolites,granular cells and death spermatozoa may consume lots of energy in the culture medium due to longer co-incubation of oocytes and high concentration...In conventional in vitro fertilization（IVF）.since sperm metabolites,granular cells and death spermatozoa may consume lots of energy in the culture medium due to longer co-incubation of oocytes and high concentration spermatozoa.The oocytes are in innutritive environment,which leads to the hardening of oocyte plasma membrane. At the same time,the high levels of estradiol（E2） and progestone（P） produced by granular cells have direct toxic effects to affect embryo cleavage,development and implantation.Therefore,short-term insemination is adopted in more and more reproductive centers. 1.Short-term insemination may increase oocyte-utilization rate,high-quality embryo rate and embryo-utilization rate.2.Retention of cumulus cells may reduce polyspermic fertilization rate.Studies have indicated that the polyspermic fertilization rate is significantly higher in cumulus cell-free group than in cumulus cell group.In short-term insemination,the remaining oocytes should retain cumulus cells to reduce polyspermic fertilization under the circumstance of successful fertilization.3.There is no significant difference in 2PN embryo chromosome abnormality between conventional IVF group and short-term insemination group.4.Short-term insemination may significantly decrease ICSI rate and partial ICSI rate.5.Complete fertilization failure rate significantly decreases in short-term insemination. Short-term insemination reduces unfavourable factors for embryo development,therefore increases high quality embryo rate.If short-term insemination is adopted in IVF,under the circumstance of successful fertilization,the remaining oocytes should retain cumulus cells as much as possible to reduce polyspermic fertilization,improve oocyteutilization rate and optimize IVF outcomes.展开更多
Objective To investigate clinical outcomes in patients who were at more precise criteria risks for fertilization failure and were treated with selective, short-term fertilization （oocytes and sperm co-incubated for ...Objective To investigate clinical outcomes in patients who were at more precise criteria risks for fertilization failure and were treated with selective, short-term fertilization （oocytes and sperm co-incubated for 4 h） and early rescue intracytoplasmic sperm injection （ICSI）. Methods A retrospective analysis was performed on 2023 women undergoing assisted reproductive technology （ART）. They were assigned to 4 groups： short-term in vitro fertilization （short-term IVF,, group A, n=217）, regular IVF （oocytes and sperm coincubated overnight, group B, n=1475）, short-term IVF and early rescue ICSI （shortterm ICSI, group C, n=94）, and regular ICSI （group D, n=237）. Results In group A, 69.8% （217/311） achieved normal fertilization rates, and the complete fertilization failure rate （fertilization rate was 0%） was 12.9% （40/311）. But all of the fertilization failure oocytes got rescue ICSI. In group B, the complete fertilization failure rate was 1.1% （19/1 692）. The fertilization rate, 2 PN （pronucleus） rate, and i PN rate were significantly lower in group A than those in group B （70.9% vs 80.8%, 57.8% vs 66.3%, and 3.5% vs 6.2%, respectively）. No significant differences were observed in clinical pregnancy rates and birth defect rates between groups A and B. The fertilization rates in groups C and D did not significantly differ （77.9% vs 76.2%）, which was also true for birth defect rates. The clinical pregnancy rate of group C was higher than that of group D （51.2% vs 42.3%）, but this difference was not significant （P〉0. 05）.Conclusion These results suggested that selective, short-term fertilization can result in effective outcomes for patients who were at high risk for fertilization failure.展开更多
文摘In conventional in vitro fertilization（IVF）.since sperm metabolites,granular cells and death spermatozoa may consume lots of energy in the culture medium due to longer co-incubation of oocytes and high concentration spermatozoa.The oocytes are in innutritive environment,which leads to the hardening of oocyte plasma membrane. At the same time,the high levels of estradiol（E2） and progestone（P） produced by granular cells have direct toxic effects to affect embryo cleavage,development and implantation.Therefore,short-term insemination is adopted in more and more reproductive centers. 1.Short-term insemination may increase oocyte-utilization rate,high-quality embryo rate and embryo-utilization rate.2.Retention of cumulus cells may reduce polyspermic fertilization rate.Studies have indicated that the polyspermic fertilization rate is significantly higher in cumulus cell-free group than in cumulus cell group.In short-term insemination,the remaining oocytes should retain cumulus cells to reduce polyspermic fertilization under the circumstance of successful fertilization.3.There is no significant difference in 2PN embryo chromosome abnormality between conventional IVF group and short-term insemination group.4.Short-term insemination may significantly decrease ICSI rate and partial ICSI rate.5.Complete fertilization failure rate significantly decreases in short-term insemination. Short-term insemination reduces unfavourable factors for embryo development,therefore increases high quality embryo rate.If short-term insemination is adopted in IVF,under the circumstance of successful fertilization,the remaining oocytes should retain cumulus cells as much as possible to reduce polyspermic fertilization,improve oocyteutilization rate and optimize IVF outcomes.
基金supported by Science and Information Technology of Guangzhou(2012Y2-00022)
文摘Objective To investigate clinical outcomes in patients who were at more precise criteria risks for fertilization failure and were treated with selective, short-term fertilization （oocytes and sperm co-incubated for 4 h） and early rescue intracytoplasmic sperm injection （ICSI）. Methods A retrospective analysis was performed on 2023 women undergoing assisted reproductive technology （ART）. They were assigned to 4 groups： short-term in vitro fertilization （short-term IVF,, group A, n=217）, regular IVF （oocytes and sperm coincubated overnight, group B, n=1475）, short-term IVF and early rescue ICSI （shortterm ICSI, group C, n=94）, and regular ICSI （group D, n=237）. Results In group A, 69.8% （217/311） achieved normal fertilization rates, and the complete fertilization failure rate （fertilization rate was 0%） was 12.9% （40/311）. But all of the fertilization failure oocytes got rescue ICSI. In group B, the complete fertilization failure rate was 1.1% （19/1 692）. The fertilization rate, 2 PN （pronucleus） rate, and i PN rate were significantly lower in group A than those in group B （70.9% vs 80.8%, 57.8% vs 66.3%, and 3.5% vs 6.2%, respectively）. No significant differences were observed in clinical pregnancy rates and birth defect rates between groups A and B. The fertilization rates in groups C and D did not significantly differ （77.9% vs 76.2%）, which was also true for birth defect rates. The clinical pregnancy rate of group C was higher than that of group D （51.2% vs 42.3%）, but this difference was not significant （P〉0. 05）.Conclusion These results suggested that selective, short-term fertilization can result in effective outcomes for patients who were at high risk for fertilization failure.
文摘目的:研究短方案超促排卵过程中过早黄素化对IVF结局的影响。方法:回顾性分析299个促排卵周期。结果:孕酮(P)水平随促排卵的进程呈上升趋势,在hCG注射后d1达峰值;P水平与E2和卵子数目有关,与LH无明显相关;当hCG注射日P>1.6 ng/ml时,临床妊娠率显著下降[40.4% vs 54.5%(P≤1.6 ng/ml)],而且随着P的进一步升高,临床妊娠率进一步下降;P升高并未影响受精率、优质胚胎率和胚胎数量。结论:P>1.6ng/ml提示了过早黄素化的出现,预示了临床妊娠率降低。
