激光辅助孵化改善隐匿精子症患者低等级卵裂胚囊胚形成并妊娠一例

doi:10.12280/gjszjk.20260051

摘要/Abstract

摘要：

辅助生殖技术中，低等级卵裂胚（low-grade cleavage embryo，LGCE）因形成可利用囊胚的概率较低，难以得到满意的助孕结局。报告1例35岁隐匿精子症患者因计划二胎未避孕未育2年余就诊，诊断为继发性男性不育。其配偶31岁，夫妻双方行辅助生殖助孕。第1个取卵周期取卵16枚，卵胞质内单精子注射（intracytoplasmic sperm injection，ICSI）10枚，D3均为LGCE（Ⅲ~Ⅳ级），囊胚培养后未形成可利用囊胚。第2个取卵周期取卵18枚，ICSI共11枚，D3仍为LGCE，移植2枚鲜胚未孕，剩余胚胎囊胚培养，采用激光辅助孵化（laser-assisted hatching，LAH）改善LGCE囊胚形成，最终形成1枚3BC囊胚冷冻保存，后续经冻融胚胎移植获得活产。通过回顾该患者的LGCE处理过程，探讨从实验室方面尝试改善隐匿精子症患者LGCE囊胚形成，提高患者的妊娠概率。

关键词: 激光辅助孵化, 低等级卵裂胚, 隐匿精子症, 精子注射，细胞质内, 妊娠

Abstract:

In assisted reproductive technology, the low-grade cleavage embryo (LGCE) is associated with a lower probability of developing into viable blastocysts, making it difficult to achieve satisfactory outcomes. We report a case of a 35-year-old male patient with cryptozoospermia who sought medical attention after more than two years of unprotected intercourse without conception while attempting to have a second child. He was diagnosed with secondary male infertility. His 31-year-old spouse underwent assisted reproductive technology with him. In the first oocyte retrieval cycle, 16 oocytes were retrieved, and 10 underwent intracytoplasmic sperm injection (ICSI). On Day 3, all embryos were LGCE (Grade Ⅲ-Ⅳ), and no viable blastocysts were formed following blastocyst culture. In the second oocyte retrieval cycle, 18 oocytes were retrieved, and 11 underwent ICSI. On Day 3, the embryos remained LGCE. Two fresh embryos were transferred, but did not result in pregnancy. The remaining embryos underwent blastocyst culture, and laser-assisted hatching (LAH) was employed to improve LGCE blastocyst formation, ultimately resulting in one 3BC-grade blastocyst that was cryopreserved. A live birth was subsequently achieved following a frozen-thawed embryo transfer cycle. By summarizing the management of this patient's LGCE, we explore the laboratory strategy to improve the blastocyst formation of LGCE in patients with cryptozoospermia, and to enhance their chances of pregnancy.

Key words: Laser-assisted hatching, Low-grade cleavage embryo, Cryptozoospermia, Sperm injections, intracytoplasmic, Pregnancy

唐雪琼, 吴晓丹, 李登坤, 张静, 苏果. 激光辅助孵化改善隐匿精子症患者低等级卵裂胚囊胚形成并妊娠一例[J]. 国际生殖健康/计划生育杂志, 2026, 45(4): 290-293.

TANG Xue-qiong, WU Xiao-dan, LI Deng-kun, ZHANG Jing, SU Guo. Laser-Assisted Hatching Improves Blastocyst Formation from Low-Grade Cleavage Embryos in Patients with Cryptozoospermia and Achieves Pregnancy: A Case Report[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(4): 290-293.

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