辅助卵母细胞激活改善高龄女性胚胎发育潜能及整倍性的影响

doi:10.3969/j.issn.2095-5340.2026.05.002

发育医学电子杂志

2026, Vol. 14

Issue (5): 376-383 DOI: 10.3969/j.issn.2095-5340.2026.05.002

生长发育论著

辅助卵母细胞激活改善高龄女性胚胎发育潜能及整倍性的影响

刘延　李招娣　胡煜　汪翔　孙宁霞

海军军医大学第二附属医院　生殖医学中心，上海　200003

Effect of assisted oocyte activation improves embryonic developmental potential and euploidy in elderly women

Liu Yan, Li Zhaodi, Hu Yu, et al

Reproductive Medicine Center, the Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China

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摘要

目的　探讨辅助卵母细胞激活（assisted oocyte activation，AOA）对既往体外受精周期中胚胎结局不良的高龄女性患者胚胎发育潜能及整倍性的影响。方法　采用回顾性自身对照研究，选取 2021 年 1 月至 2024 年 12 月在海军军医大学第二附属医院生殖医学中心行卵胞质内单精子注射（intracytoplasmic sperm injection，ICSI）助孕并使用钙离子载体 A23187 进行激活的高龄女性患者（年龄≥ 35 岁）作为 AOA 组（n=123），患者既往 ICSI 周期胚胎结局和妊娠结局作为对照组（n=123），对比并分析 2 组的双原核受精率、优质胚胎率、囊胚形成率、优质囊胚率、胚胎整倍体率及临床妊娠率。统计学分析采用独立样本 t 检验、χ2 检验或 Fisher 确切概率法。结果　在低双原核受精率患者中，AOA组双原核率明显高于对照组 [77.27%（17/22）与 18.18%（4/22），P<0.001]。在低优质胚胎率的患者中，AOA 组优质胚胎率、囊胚形成率和优质囊胚率均高于对照组 [59.46%（110/185）与 15.38%（22/143），52.87%（83/157）与 28.95%（33/114），72.29%（60/83）与 33.33%（11/33），χ2 值分别为 65.153、15.434、15.091，P 值均 <0.001]。在低囊胚形成率患者中，AOA 组囊胚形成率亦高于对照组 [56.33% （169/300）与 26.71% （74/277），χ2 值为 51.826，P<0.001]。在 ICSI- 胚胎植入前遗传学检测（preimplantation genetic

testing，PGT）周期中，AOA 组优质胚胎率、囊胚形成率和胚胎整倍体率均高于对照组 [71.95%（277/385）

与 61.09%（168/275），59.48%（229/385）与 35.64%（98/275），39.37%（87/221）与 23.08% （21/91），χ2 值分别为 8.609、36.485、7.557，P 值均 <0.05]。冻融胚胎移植周期 AOA 组临床妊娠率高于对照组 [72.34%（34/47）与 16.67%（2/12），P<0.001]。结论　AOA 可能提高高龄女性患者的胚胎发育潜能，增加优质胚胎以及可用囊胚数，继而提高患者的胚胎整倍体率，对于改善高龄女性患者的妊娠结局有一定积极作用。

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关键词: 辅助卵母细胞激活')" href="#">

辅助卵母细胞激活高龄胚胎发育潜能胚胎整倍性钙离子载体 A23187

Abstract:

Objective To explore the effect of assisted oocyte activation (AOA) on the developmental potential and the euploidy in elderly women with poor embryo outcomes in previous in vitro fertilization cycles. Methods A retrospective self-controlled study was conducted to analyze elderly women (aged ≥35 years) who underwent intracytoplasmic sperm injection (ICSI) combined with calcium ionophore A23187-AOA at the Reproductive Medicine Center, The Second Affiliated Hospital of Naval Medical University from January 2021 to December 2024, these cases were assigned to the AOA group (n=123), their embryonic and pregnancy outcomes from previous ICSI cycles served as the control group (n=123). The two-pronucleus (2PN) fertilization rate, high-quality embryo rate, blastocyst formation rate, high-quality blastocyst rate, embryonic euploidy rate, and clinical pregnancy rate of the two groups were compared and analyzed. Statistical analysis were performed using the t-test, χ2 test or Fisher exact probability method. Results In patients with a low rate of 2PN fertilization, the 2PN rate in the AOA group was significantly higher than that in the control group [77.27% (17/22) vs 18.18% (4/22), P<0.001]. In patients with a low rate of high-quality embryos, the rates of high-quality embryos, blastocyst formation, and high-quality blastocysts in the AOA group were all higher than those in the control group [59.46% (110/185) vs 15.38% (22/143), 52.87% (83/157) vs 28.95% (33/114), and 72.29% (60/83) vs 33.33% (11/33), respectively; χ2 values were 65.153, 15.434, and 15.091, respectively; all P<0.001]. In patients with a low rate of blastocyst formation, the blastocyst formation rate in the AOA group was also higher than that in the control group [56.33% (169/300) vs 26.71% (74/277), χ2 value was 51.826, P<0.001]. In the ICSI preimplantation genetic testing (PGT) cycles, the AOA group showed significantly higher rates of high quality embryos, blastocyst formation, and embryonic euploidy compared with the control group [71.95% (277/385) vs 61.09% (168/275), 59.48% (229/385) vs 35.64% (98/275), and 39.37% (87/221) vs 23.08%

(21/91), respectively; χ2 values were 8.609, 36.485, and 7.557, respectively; all P<0.05]. In frozen–thawed

embryo transfer cycles, the clinical pregnancy rate in the AOA group was significantly higher than that in the control group [72.34% (34/47) vs 16.67% (2/12), P<0.001]. Conclusions AOA may improve the embryonic developmental potential of elderly women, increase the number of high-quality embryos and available blastocysts, thereby improving the embryonic euploidy rate of the patient. It has a certain positive effect on improving pregnancy outcomes in elderly women.

Key words: Assisted oocyte activation')" href="#">

Assisted oocyte activation Elderly Embryonic developmental potential euploidy')" href="#">Embryonic

euploidy Calcium ionophore A23187

收稿日期: 2025-12-18 出版日期: 2026-09-30 发布日期: 2026-09-30 期的出版日期: 2026-09-30

基金资助:

国家重点研发计划（2022YFA1303902）；国家自然科学基金（82271662）；上海市卫生健康学科带

头人项目（2022XD003）

通讯作者: 孙宁霞 E-mail: suesunchzh@126.com

引用本文:

刘延　李招娣　胡煜　汪翔　孙宁霞.

辅助卵母细胞激活改善高龄女性胚胎发育潜能及整倍性的影响

[J]. 发育医学电子杂志, 2026, 14(5): 376-383.
Liu Yan, Li Zhaodi, Hu Yu, et al.

Effect of assisted oocyte activation improves embryonic developmental potential and euploidy in elderly women

. Journal of Developmental Medicine(Electronic Version), 2026, 14(5): 376-383.

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http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2026.05.002 或 http://www.fyyxzz.com/CN/Y2026/V14/I5/376

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