低比例多原核受精对胚胎发育参数和临床妊娠结局的影响

doi:10.3969/j.issn.2095-5340.2022.05.004

发育医学电子杂志

2022, Vol. 10

Issue (5): 346-352 DOI: 10.3969/j.issn.2095-5340.2022.05.004

生殖胚胎论著

低比例多原核受精对胚胎发育参数和临床妊娠结局的影响

朱元昌　袁琳　谭芳　马壮鸿　邓伟芬

深圳恒生医院　生殖医学科，广东　深圳　518034

Effects of low frequency poly-pronuclear on embryo development parameters and clinical pregnancy outcome of patients with in vitro fertilization-embryo transfer treatment

Zhu Yuanchang, Yuan Lin, Tan Fang, et al

(Department of Reproductive Medicine, Shenzhen Hengsheng Hospital, Guangdong, Shenzhen 518034, China)

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摘要 【摘要】目的　探讨常规体外受精（in vitro fertilization，IVF）周期中不同比例多原核受精对胚胎发育参
数及临床妊娠结局的影响。　方法　回顾性分析2020 年1 月至12 月在深圳恒生医院生殖医学科行体外受精与胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）治疗的不孕不育患者。纳入治疗后获卵数>5 枚的638 个周期，根据多原核受精比例，将638 个周期分为3 组：无多原核组、低比例多原核组（≤ 10%）和高比例多原核组（>10%），比较3 组之间胚胎发育参数及临床妊娠结局。统计学方法采用单因素方差分析、 t 检验、χ²检验。　结果　低比例多原核组女方患者的平均年龄低于无多原核组和高比例多原核组［（33±4）、（34±5）、（34±5）岁，F=4.358，P<0.05］。无多原核组、低比例多原核组和高
比例多原核组的抗米勒管激素水平分别为［（3.8±2.5）、（5.1±2.9）、（3.8±3.0）μg/L，F=10.614，P<0.001］，平均获卵数分别为［（10.6±5.1）、（17.4±6.5）、（11.4±6.4）枚，F=65.357P<0.001］，低比例多原核组均高于其他2 组（P<0.05）。高比例多原核组的优质胚胎率高于无多原核组［44.2% （546/1 235）、41.2%（977/2 371），χ²=1.942，P<0.05）。高比例多原核组和低比例多原核组中的可利用囊胚［64.1%（366/571）、64.8%（529/816）］和优质囊胚［（42.4% （242/571）、40.6% （331/816）］高于无多原核组［59.8% （642/1 073）、33.8%（ 363/1 073）］，差异均有统计学意义（χ2=3.579、3.854、5.982、5.421，P值均 <0.05）。高比例多原核组的临床妊娠率明显低于无多原核组和低比例多原核组［65.3% （49/75）、70.3% （104/148）、70.6% （24/34）,χ²=1.435、0.962，P 值均<0.05］。低比例多原核组的胚胎种植率高于无多原核组和高比例多原核组［56.% （31/55）、47.8% （131/274）、47.4% （63/133）, χ²=1.273、1.945，P 值均<0.05］。结论　在IVF 周期中存在低比例（≤ 10%）多原核受精，能获得较好的临床妊娠率和胚胎种植率。

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关键词: 体外受精多原核受精优胚率临床妊娠率种植率

Abstract: 【Abstract】 Objective To investigate effects of low frequency poly-pronuclear on embryo development
parameters and clinical pregnancy outcome of patients with in vitro fertilization (IVF).　Method　From
January 1 to December 31, 2020, the infertility patients who underwent in vitro insemination and
embryo transfer (IVF-ET) in the Department of Reproductive Medicine, Shenzhen Hengsheng Hospital
were retrospectively analyzed. A total of 638 cycles with more than 5 eggs obtained were included.
All patients were divided into three groups according to the ratio of poly-pronuclear zygotes: normal
fertilization group, low frequency poly-pronuclear zygotes group (≤10%) and high frequency poly-
pronuclear zygotes group (>10%), the embryo development parameters and clinical pregnancy outcomes
were compared among the three groups. One-way analysis of variance (ANOVA), t-test and χ2-test were
applied as statistical approaches.　Result　The female average age of low frequency poly-pronuclear
zygotes group was lower than that in normal fertilization group and high frequency poly-pronuclear zygotesgroup [(33±4), (34±5), (34±5) years, F=4.358, P<0.05]. Low frequency poly-pronuclear zygotes
group was higher than the other groups in Anti-millerian hormone levels [(3.8±2.5), (5.1±2.9),
(3.8±3.0) μg/L, F=10.614, P<0.001] and mean number of eggs retrieved [(10.6±5.1), (17.4±6.5),
(11.4±6.4), F=65.357, P<0.001]. High frequency poly-pronuclear zygotes group was higher than
normal fertilization group in high quality embryo rate [44.2% (546/1 235) vs 41.2% (977/2 371),
χ2=1.942, P<0.05]. High frequency poly-pronuclear zygotes group and low frequency poly-pronuclear
zygotes group were higher than normal fertilization group in available blastocyst [64.1% (366/571),
64.8 (529/816), 59.8% (642/1 073)] and high quality blastocysts [(42.4% (242/571), 40.6% (331/816),
33.8% (363/1 073)], which was statistically significant (χ²=3.579, 3.854, 5.982, 5.421, all P<0.05).
Low frequency poly-pronuclear zygotes group were higher than normal fertilization group and high
frequency poly-pronuclear zygotes group in embryo implantation rate [56.4% (31/55), 47.8% (131/274),
47.4%(63/133), χ²=1.273, 1.945, all P<0.05].　Conclusion　 In IVF cycles, there is a low frequency
(≤10%) of poly-pronuclear insemination, which can obtain a better clinical pregnancy rate and embryo
implantation rate.

Key words: In vitro fertilization Poly-pronuclear Top embryo rate Clinical pregnancy rate Implantationrate

收稿日期: 2021-12-24 发布日期: 2022-09-30

基金资助: 国家自然科学基金（82060281）；广东省医学科研基金 (A2022359)

通讯作者: 邓伟芬 E-mail: dweifen@sina.com

引用本文:

朱元昌　袁琳　谭芳　马壮鸿　邓伟芬. 低比例多原核受精对胚胎发育参数和临床妊娠结局的影响[J]. 发育医学电子杂志, 2022, 10(5): 346-352.
Zhu Yuanchang, Yuan Lin, Tan Fang, et al. Effects of low frequency poly-pronuclear on embryo development parameters and clinical pregnancy outcome of patients with in vitro fertilization-embryo transfer treatment. Journal of Developmental Medicine(Electronic Version), 2022, 10(5): 346-352.

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