国际生殖健康/计划生育 ›› 2019, Vol. 38 ›› Issue (5): 367-369.

• 论著 • 上一篇    下一篇

拮抗剂方案OPU-ICSI不同时机选择对新鲜胚胎移植周期临床结局的影响

陈威,周莉娜,吴煜,张箴波,孙健   

  1. 201620 上海交通大学附属第一人民医院生殖医学科
  • 收稿日期:2019-04-30 修回日期:2019-06-20 出版日期:2019-09-15 发布日期:2019-09-11
  • 通讯作者: 吴煜,E-mail:yuwu818@163.com E-mail:44030455@qq.com
  • 基金资助:
    上海交通大学“医工交叉基金”(YG2016MS27)

Effects of Regimens OPU-ICSI with Different Intervals on the Clinical Outcomes of Fresh Embryo Transfer in GnRH Antagonist Cycle

CHEN Wei,ZHOU Li-na,WU Yu,ZHANG Zhen-bo,SUN Jian   

  1. Department of Reproductive Medicine,Shanghai General Hospital,Shanghai Jiaotong University,Shanghai 201620,China
  • Received:2019-04-30 Revised:2019-06-20 Published:2019-09-15 Online:2019-09-11
  • Contact: WU Yu,E-mail:yuwu818@163.com E-mail:44030455@qq.com

摘要: 目的:比较促性腺激素释放激素(GnRH)拮抗剂方案中选择不同的胞浆内单精子注射(ICSI)实施时机对新鲜胚胎移植周期中胚胎质量及妊娠结局的影响。方法:选择2016年1月—2018年5月在我科采用GnRH拮抗剂方案促排卵,行新鲜胚胎移植的531个周期,按不同取卵(OPU)-ICSI间隔时间分为2组:38~40 h为组1(n=101),41~43 h为组2(n=430),比较2组患者的卵母细胞成熟度、胚胎质量和妊娠结局。结果:组1患者的卵子成熟率低于组2,但组2 的早期流产率低于组1,差异有统计学意义(均P<0.05)。2组患者的受精率、分裂率、可利用胚胎率、优胚率、种植率和临床妊娠率等比较,差异无统计学意义(均P>0.05)。结论:在GnRH拮抗剂方案新鲜胚胎移植周期中,ICSI时机选择在38~43 h的窗口期均能达到比较一致的胚胎质量及临床妊娠率。关于OPU-ICSI间隔短(小于40 h)早期流产率较高,需要更多的和细致分组的研究。

关键词: 精子注射, 细胞质内, 体外受精, 胚胎移植, 促性腺素释放激素, OPU-ICSI间隔

Abstract: Objective:To compare the effects of two different ICSI insemination times on the reproductive outcomes of fresh embryo transfer (FET) in gonadotropin-releasing hormone (GnRH) antagonist cycles. Methods:531 cycles of FET after the GnRH antagonist protocol were divided into two groups according to the interval time between OPU and ICSI, the group one (n=101) that the OPU-ICSI interval was ranged from 38~40 h and the group two (n=430) was 41~43 h. The differences of oocyte maturation rate, embryo quality and pregnancy outcomes between the two groups were analyzed retrospectively. Results:The oocyte maturation rate was significantly lower in the group one when compared with the group two (P<0.05), and the miscarriage rate in group one was significantly higher (P<0.05). There was no significant differences in the fertility rate, cleavage rate, available embryo rate, high-quality embryo rate, implant rate and pregnancy rate between the two groups (P>0.05). Conclusions:Our results indicate that there are relatively consistent embryo quality and clinical pregnancy rate in the timing of ICSI ranged from 38~43 h. As for the finding that the miscarriage rate could be higher if the ICSI time was earlier than 40 h in the FET cycle of GnRH antagonist protocol, we think that more studies with large samples and the detailed grouping may be necessary.ds: 531 patients were divided into two groups according to times between hCG and ICSI from January 2016 to May 2018. The hCG-ICSI interval ranged from 38h to 40h was group one (including 101 cases) and 41h-43h was group two (including 430 cases). The differences of oocyte maturation rate, quality of embryo and reproductive outcomes between the two groups were analyzed retrospectively. Result: The oocyte maturation rate of Group one was significantly lower than Group two (P<0.05), furthermore miscarriage rates when ICSI was performed 38-40 hours in Group one was significantly higher than Group two(P<0.05). There was no significant difference in fertility rates, cleavage rates, available embryo rates, high-quality embryo rates, implant rates and pregnancy rates between the two groups (P>0.05). Conclusion: Our results indicate that the effective window of time for insemination by ICSI might be wider than previously thought, while we also noted that the higher miscarriage rate was obtained after the earlier injection in the fresh embryo transfer cycle of GnRH antagonist.

Key words: Sperm injections, intracytoplasmic, Fertilization in vitro, Embryo transfer, Gonadotropin-releasing hormone, OPU-ICSI interval