短时受精中不同受精结局组间精子-透明质酸结合率及妊娠率的比较

发布时间：2018-07-23 13:33

【摘要】：目的探讨精子-透明质酸结合率对受精能力的预测以及妊娠的影响。方法回顾性分析2016年1月—6月期间本中心正常受精的短时体外受精(IVF)患者1 630例作为对照组(短时IVF组),因短时受精失败行补救卵胞质内单精子注射(ICSI)的130例作为研究组(R-ICSI组),检测并分析两组精液的精子-透明质酸结合率、浓度、前向运动率、正常形态率、胚胎质量以及妊娠结局。结果 (1)女方年龄、不孕年限、总Gn用量、Gn使用时间以及获卵数组间均无统计学差异(P0.05);(2)R-ICSI组的精子-透明质酸结合率[(63.8±17.4)%]显著低于短时IVF组[(71.8±13.6)%](P0.01),并同时伴有精子浓度和正常形态率的明显下降(P0.05),但其均值却仍然高于精液常规参数的正常参考值;(3)R-ICSI组的正常受精率(70.8%)、总受精率(76.2%)及优质胚胎率(50.0%)均显著低于短时IVF组(76.01%,85.0%,59.0%)(P0.01);(4)R-ICSI组平均移植胚胎数(2.0±0.2)显著高于短时IVF组(1.9±0.3)(P0.01),但种植率(36.6%)却仍然低于短时IVF组(49.0%)(P0.05);R-ICSI组临床妊娠率低于短时IVF组,胚胎停育率高于短时IVF组,但两者之间的差异并无统计学意义(P0.05)。结论精子-透明质酸结合率对IVF有一定的预测作用,结合常规参数,精子-透明质酸结合率低于63.8%时,受精失败风险增加,但其对于妊娠的影响还有待于进一步研究。
[Abstract]:Objective to study the effect of sperm-hyaluronic acid binding rate on fertilization ability and pregnancy. Methods from January to June 2016, 1 630 (IVF) patients with normal fertilization in our center were used as control group (short term IVF group). 130 cases of (ICSI) were injected into the oocyte due to the failure of short term fertilization. As a study group (R-ICSI group), sperm-hyaluronic acid binding rates were measured and analyzed in both groups. Concentration, forward motion rate, normal form rate, embryo quality, and pregnancy outcome. Results (1) the age of the woman, the length of her infertility, The sperm hyaluronic acid binding rate of R-ICSI group [(63.8 卤17.4)%] was significantly lower than that of short-term IVF group [(71.8 卤13.6)%] (P0.01), accompanied by a significant decrease in sperm concentration and normal morphology (P0.05). (3) the normal fertilization rate (70.8%), total fertilization rate (76.2%) and high quality embryo rate (50.0%) in R-ICSI group were significantly lower than those in short-term IVF group (76.01%) (85.0%) (P0.01); (4) and the average number of embryos transferred in R-ICSI group (2.0 卤0.2) was significantly higher than that in short-term IVF group (1.9 卤0.3) (P0.01). The clinical pregnancy rate of R-ICSI group (36.6%) was still lower than that of short-term IVF group (49.0%) (P0.05), and the clinical pregnancy rate of R-ICSI group was lower than that of short-term IVF group. The embryo suspension rate was higher than that in the short term IVF group, but there was no significant difference between the two groups (P0.05). Conclusion the sperm hyaluronic acid binding rate can predict IVF to some extent. When the sperm hyaluronic acid binding rate is lower than 63.8, the risk of fertilization failure increases, but the effect on pregnancy needs further study.
【作者单位】：深圳市武警医院生殖中心;
【分类号】：R714.8

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