国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2019, Vol. 38 ›› Issue (3): 190-193.

• 论著 • 上一篇    下一篇

自体血清体外成熟培养液卵胞浆优化在首次ICSI治疗中的应用

纪冬梅，章志国，邹薇薇，邓晓红，陈蓓丽，周平，魏兆莲，曹云霞   

  1. 230022 合肥，安徽医科大学第一附属医院妇产科生殖医学中心，安徽医科大学生殖健康与遗传安徽省重点实验室，安徽省生命资源保存与人工器官工程技术研究中心
  • 收稿日期:2019-03-05 修回日期:2019-04-10 出版日期:2019-05-15 发布日期:2019-05-16
  • 通讯作者: 曹云霞，E-mail：caoyunxia6@126.com E-mail:caoyunxia6@126.com
  • 基金资助:
    国家自然科学基金（81601345）；国家重点研发计划（2017YFC1001300）

Application of Ooplasm Optimization in IVM Medium Containing Autologous Serum in Patients Undergoing Their First ICSI Cycles

JI Dong-mei，ZHANG Zhi-guo，ZOU Wei-wei，DENG Xiao-hong，CHEN Bei-li，ZHOU Ping，WEI Zhao-lian，CAO Yun-xia   

  1. Reproductive Medicine Center，Department of Obstetrics and Gynecology，The First Affiliated Hospital of Anhui Medical University，Anhui Province Key Laboratory of Reproductive Health and Genetics，Biopreservation and Artificial Organs，Anhui Provincial Engineering Research Center，Anhui Medical University，Hefei 230022，China
  • Received:2019-03-05 Revised:2019-04-10 Published:2019-05-15 Online:2019-05-16
  • Contact: CAO Yun-xia，E-mail：caoyunxia6@126.com E-mail:caoyunxia6@126.com

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摘要： 目的：探讨自体血清体外成熟培养（IVM）液卵胞浆优化对首次行胞浆内单精子注射（ICSI）助孕患者的应用价值。方法：选择2017年1月—2018年7月在安徽医科大学第一附属医院生殖医学中心（我中心）首次行ICSI助孕的不孕症患者共1 074例，根据取卵日有无采用自体血清配制的IVM液培养设为血培组（819例）和非血培组（255例）。血培组取卵后IVM培养2～4 h行ICSI授精，非血培组取卵后在常规受精液中培养2～4 h行ICSI授精。比较2组患者的一般情况、胚胎发育情况和临床结局。结果：2组患者的年龄、不孕时间、体质量指数（BMI）、基础卵泡刺激素（FSH）和基础黄体生成激素（LH）水平比较，差异均无统计学意义（均P＞0.05）。血培组患者的获卵数、受精率、囊胚形成率稍高于非血培组，非血培组的优质囊胚率稍高于血培组，但是差异均无统计学意义（均P＞0.05）。血培组中47例、非血培组中22例行新鲜周期胚胎移植。2组患者新鲜移植周期的年龄、基础FSH水平、hCG日子宫内膜厚度、移植胚胎数、临床妊娠率、周期取消率和胚胎种植率比较，差异均无统计学意义（均P＞0.05），血培组流产率显著降低（6.25% vs. 36.36%）、活产/继续妊娠率显著增加（93.75% vs. 63.64%），差异有统计学意义（均P＜0.05）。结论：对于常规首次行ICSI助孕的患者，采用自体血清短时间培养与常规受精液培养相比可降低流产率，改善妊娠结局。

关键词: 精子注射, 细胞质内, 胚胎培养技术, 自体血清, 体外成熟

Abstract: Objective：To evaluate the role of short time incubation with in vitro maturation (IVM) medium containing 20% autologous serum in patients undergoing their first intracytoplasmic sperm injection (ICSI) cycles. Methods：Between January 2017 and July 2018, a total of 1 074 patients undergoing their first ICSI cycles were evaluated retrospectively. Patients were divided into the serum incubation group (n=819) and the non-serum incubation group (n=255), according to whether oocytes were in vitro cultured with the IVM medium containing 20% autologous serum or the routine fertilization medium for 2-4 h prior to sperm injection on the day of oocyte collection. General data, embryonic development and clinical outcomes of the two groups were compared. Results：There was no significant difference between the two groups in age, duration of infertility, body mass index, basal levels of FSH and LH (P＞0.05). The average number of oocytes collected, oocytes maturation rate, fertilization rate and blastocyst formation rate in the serum incubation group were slightly higher than those in non-IVM group, the high-quality blastocyst rate was slightly lower in the serum culture group, however there were no significant differences between the two groups (all P＞0.05). Fresh embryo transfer was performed in 47 cases in the serum culture group and 22 cases in the non-serum culture group. There was no significant difference in the age, basal level of FSH, endometrial thickness, number of embryos transferred, clinical pregnancy rate, cycle cancellation rate and implantation rate between the two groups for patients undergoing fresh embryo transfer (all P＞0.05). Interestingly, the abortion rate was significantly reduced (6.25% vs. 36.36%), and the live birth/continued pregnancy rate increased (93.75% vs. 63.64%) in the serum incubation group (both P＜0.05). Conclusions：The short time incubation of oocytes in the IVM medium containing 20% autologous serum for 2-4 h before ICSI can significantly reduce the abortion rate, in those patients undergoing ICSI treatment for the first time.

Key words: Sperm injections, intracytoplasmic, Embryo culture techniques, Autologous serum, In vitro maturation