多精受精对胚胎发育及临床结局的影响-第三军医大学学报.DOCVIP

多精受精对胚胎发育及临床结局的影响 [摘要] 目的 了解体外受精-胚胎移植(IVF-ET)过程中多精受精对胚胎发育及妊娠结局的影响。方法 回顾性分析在本中心2010年至2012年IVF－ET治疗的资料，根据多精受精率分为三组:第1组，多精受精率等于零的正常受精; 第2组，多精受精率大于零小于等于25%，第3组，多精受精率大于25%。比较各组的平均年龄、平均获卵数、成熟卵率、2PN正常受精率(2PN)、正常受精卵裂率(2PN)、正常受精优胚率(2PN)及临床妊娠率。结果 共分析了1144个IVF-ET周期的资料，其中第1组有593个周期，2组有449个周期，3组只有102个周期。除了正常受精卵裂率，三组的成熟卵率、正常受精率、正常受精优胚率、临床妊娠率均有差异 结论 多精受精提示促排的卵成熟率高、优胚率高，低水平多精受精率不影响临床妊娠率，但高发周期会降低临床妊娠率。 关键词：多精受精；体外受精-胚胎移植；临床妊娠率 Effects of polyspermy on embryo development and the clinical outcomes of in vitro fertilization and embryo transfer ［Abstract］Objection To investigate the influence of polyspermy on embryo development and the clinical outcomes of in vitro fertilization and embryo transfer. Methods Date of IVF-ET cycles were retrospectively analyzed from 2010 to 2012 in our department. Three groups were devided based on the polyspermy rate, which defined zero as first group, ＞0 and ≤25% as second group, and ＞25% as third group. Then the average number of oocytes, the rate of mature eggs, the normal (2PN) fertilization rates，the normal (2PN) cleavage rate, the good embryo rate，the clinical pregnancy rate were compared. Results A total of 1144 IVF cycles were analyzed, the cycles of three group as follow：593, 449 and 102. Difference were observed in the average number of oocytes, the rate of mature eggs, the normal (2PN) fertilization rates, the good embryo rate，the clinical pregnancy rate among three groups. Conclusion The rate of mature eggs and the good embryo rate are increase in the cycle of polyspermy，no significantly affect was observed between normal fertilization and low frequency of polyspermy, but the clinical pregnancy rate decreases in the high frequency occurring cases. Key words: Polyspermy; in vitro fertilization and embryo transfer；clinical pregnancy rate 多精受精是哺乳动物卵母细胞较普通的一种异常受精形式，指受精时有一条以上的精子进入卵母细胞从而形成多个原核的现象。多精受精在正常生理情况下很少发生，而人类体外受精胚胎移植 （in vitro fertilizati embryo transfer，IVF- ET ）过程中有 2% -10%的多精受精率[1]。多精受精卵可以发育成胚胎，但移植着床后最终会导致流产或多倍体畸形儿的发生[2,3]，因此，IVF- ET中多精受