【摘要】 目的 观察提前去除卵丘细胞对胚胎质量的影响，进一步探讨其临床应用价值。 方法 将2009年7-9月行体外受精-胚胎移植治疗的患者随机分为两组，试验组共137个周期，于授精后5 h去除卵丘细胞；对照组共146个周期，于授精后16～18 h去除卵丘细胞。两组均于授精后16～18 h观察受精情况，72 h对胚胎进行评分，选择1～3枚优质胚胎进行胚胎移植。分别比较两组的年龄、不育年限、获卵数、受精率、卵裂率、优质胚胎率、胚胎种植率和临床妊娠率。 结果 两组的优质胚胎率差异有统计学意义（P lt;0.01）；但年龄、不育年限、获卵数、受精率、卵裂率、胚胎种植率和临床妊娠率比较，差异均无统计学意义（P gt;0.05）。 结论 体外受精中提前去除卵丘细胞优质胚胎增加，有助于提高临床累积妊娠率。
【Abstract】 Objective To evaluate the effect of denuding the oocyte granulose cells soon after fertilization in vitro (IVF). Methods A total of 283 IVF cycles in patients from July to September 2009 were divided into a trial group and a control group randomly. The trial group contained 137 cycles, being denuded the oocyte granulose cells only 5 hours after IVF. The controlled group contained 146 cycles, being denuded the oocyte granulose cell and observed the pronuclear 18 hours after IVF. The outcomes of female age, infertile duration, the number of oocyte, fertilization rate,abnormal fertilization rate, good quality embryo rate, and clinical pregnancy rate were measured. Results There was no difference in any of the outcomes between the two groups except for the high quality embryo rate (P lt;0.01). The clinical pregnancy rate was higher in the trial group without significant differences (P gt;0.05). Conclusions Denuding the oocyte granulose cells soon after IVF helps to improve the embryo quality and the clinical accumulated pregnancy rate.
Citation：
UN Yanping,FANG Weifen,NIU Xiangli,GONG Fangqiang,CHEN Zihong,HUANG Hua. Effect of Denuding the Oocyte Granulose Cells Soon After Fertilization in Vitro. West China Medical Journal, 2010, 25(9): 1708-1710. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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- 1. 罗丽兰. 不孕与不育[M]. 北京: 人民卫生出版社, 1999: 418-426.
- 2. Gianaroli L, Magli MC, Ferraretti AP, et al. Reducing the time of sperm oocyte interaction in human in vitro fertilization improves the implantation rate[J]. Hum Reprod, 1996, 11(1): 166-171.
- 3. Dirnfeld M, Bider D, Koifman M, et al. Shortened exposure of oocytes to spermatozoa improves in vitro fertilization outcome: a prospective randomized controlled study[J]. Hum Reprod, 1999, 14(10): 2562-2564.
- 4. Kattera S, Chen C. Short coincubation of gametes in in vitro fertilization improves implantation and pregnancy rates: a prospective, randomized, controlled study[J]. Fertil Steril, 2003, 80(4): 1017-1021.
- 5. Tomas C, Orava M, Tuomivaara L, et al. Low pregnancy rate is achieved in patients treated with intracytoplasma sperm injection due to previous low or failed fertilization in in vitro fertilization[J]. Hum Reprod, 1998, 13(13): 65-70.
- 6. 张丽红, 王克华, 李娟, 等. 缩短受精前卵母细胞培养和精卵共孵育时间对妊娠结局的影响[J]. 生殖医学杂志, 2006, 15(2): 127-129.
- 7. Nagy ZP, Rienzi LF, Ubaldi FM, et al. Effect of reduced oocyte aging on the outcome of rescue intracytoplasmic sperm injection[J]. Fertil Steril, 2006, 85(4): 901-906.
- 8. 严正杰, 蔡令波, 冯婷, 等. 对体外受精失败后不同授精时间进行补救ICSI的结局比较[J]. 生殖与避孕, 2009, 29(5): 329-332.
- 9. Chen C, Kattera S. Rescue ICSI of oocytes that failed to extrude the second polar body 6 h post insemination in conventional IVF[J]. Hum Reprod, 2003, 18 (10): 2118-2122.
- 10. 孙海翔. 早期补救ICSI的安全性和应用价值[J]. 生殖医学杂志, 2009, 18(3): 195-197.
- 11. 张宁媛, 孙海翔, 胡娅莉, 等. 短时受精联合早期补救性卵细胞胞质内单精子注射在完全受精失败周期的临床应用[J]. 中华男科学杂志, 2009, 15 (6): 538-541.
