短时受精在体外受精-胚胎移植治疗周期中的应用价值

目的:比较IVF-ET治疗中精卵孵育不同时间对胚胎质量及治疗结局的影响。方法:189个IVF-ET周期按精卵共孵育时间不同分为短时受精组(A组,精卵共孵育2h)和传统受精组(B组,精卵孵育过夜)。两组中又根据男方精液质量是否正常分为精液正常组和精液异常组(中重度精液异常),分别比较4组的受精率、多精受精率、卵裂率、优质胚胎率、妊娠率、胚胎种植率和流产率。结果:①4组的受精率、多精受精率、卵裂率和流产率差异无统计学意义(P>0.05)。②短时受精组的优质胚胎率、临床妊娠率和胚胎种植率显著高于传统受精组(P分别<0.05、<0.01)。③短时受精中精液正常组(A1组)与精液异常组(A2组)的优质胚胎率、临床妊娠率及胚胎种植率均高于传统受精中的精液异常组(B2组,P分别<0.01或<0.05),而与传统受精中的精液正常组(B1组)比较差异均无统计学意义(P>0.05)。结论:①短时受精不影响受精率、卵裂率和流产率,可提高优质胚胎率、临床妊娠率及胚胎种植率;②短时受精不减少多精受精率;③短时受精对精液质量异常(中重度精液异常)周期治疗结果明显改善。

Application value of short time insemination in IVF-ET cycles

Objective:To compare the effect of incubation at different times in IVF-ET on quality of embryos and pregnancy outcomes.Methods:189 IVF-ET cycles were divided into short time insemination group (A group,incubation 2 hours) and conventional insemination group (B group,incubation overnight) according to the time of incubation,then the two groups were subdivided into normal semen group and abnormal semen group (moderate and severe dysspermatism) according to the quality of semen,the fertilization rate,polyspermy rate,cleavage rate,high quality embryo rate,pregnancy rate,implantation rate and abortion rate in the four groups were compared.Results:There was no significant difference in fertilization rate,polyspermy rate,cleavage rate and abortion rate among the four groups (P>0.05); the high quality embryo rate,pregnancy rate and implantation rate in short time insemination group were significantly higher than those in conventional insemination group (P<0.05,P<0.01); in short time insemination group,the high quality embryo rates,pregnancy rates and implantation rates in normal semen group (A1 group) and abnormal semen group (A2 group) were significantly higher than those in abnormal semen group (B2 group) of conventional insemination group (P<0.05,P<0.01),but there was no significant difference between normal semen group (A1 group),abnormal semen group (A2 group) in short time insemination group and normal semen group (B1 group) in conventional insemination group (P>0.05).Conclusion:Short time insemination does not affect fertilization rate,cleavage rate and abortion rate,and can increase high quality embryo rate,pregnancy rate and implantation rate; short time insemination does not reduce polyspermy rate; short time insemination can improve the outcomes of IVF-ET cycles in cases with dysspermatism.