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目的:探讨体外受精/卵胞质内单精子注射(IVF/ICSI)后移植前胚胎在不同氧浓度培养条件下的发育情况。方法:将接受IVF或ICSI的患者随机分组成常氧组(体积分数20%的氧浓度,包括IVF卵裂期胚胎患者150例,IVF囊胚期胚胎患者51例,ICSI卵裂期胚胎患者81例,ICSI囊胚期胚胎患者39例)和低氧组(体积分数5%的氧浓度,包括IVF卵裂期胚胎患者108例,IVF囊胚期胚胎患者56例,ICSI卵裂期胚胎患者79例,ICSI囊胚期胚胎患者45例),观察各组胚胎在受精后第3日的卵裂胚和第5日的囊胚发育情况以及临床妊娠结局。结果:在患者年龄、不孕年限、基础FSH值、Gn用量、获卵数和MⅡ卵率组间均无统计学差异的基础上,1与常氧组相比,低氧组的胚胎IVF或ICSI后的受精率、卵裂率以及第3日形成的优质胚胎率无统计学差异(P>0.05),临床妊娠率和着床率组间也无统计学差异(P>0.05);2低氧组胚胎IVF或ICSI后形成的Ⅴ级囊胚多于常氧组(P<0.05),总囊胚形成率组间有显著的统计学差异(P<0.01),临床妊娠率和着床率组间无统计学差异(P>0.05)。结论:与常氧培养条件相比,低氧培养条件并不能显著促进IVF/ICSI后卵裂期胚胎的发育,但能够促进囊胚的形成,特别是囊胚的孵出,因此低氧培养可以作为囊胚培养的首选条件,但不是卵裂期胚胎培养的必要条件。
OBJECTIVE: To investigate the development of preimplantation embryos cultured in IVF / ICSI under different oxygen concentrations. Methods: Patients receiving IVF or ICSI were randomly divided into normoxia group (oxygen concentration of 20%, including 150 cases of IVF cleavage stage embryo, 51 cases of IVF blastocyst stage embryo, 51 cases of ICSI cleavage stage embryo 81 (39 cases of ICSI blastocyst embryo patients) and hypoxia group (5% volume oxygen concentration, including 108 cases of IVF cleavage stage embryos, 56 cases of IVF blastocyst stage embryos, 79 cases of ICSI cleavage stage embryos Cases, 45 cases of ICSI blastocyst embryo patients), observe the embryo on the 3rd after fertilization on the 3rd day of blastocyst and blastocyst development on the 5th and the clinical pregnancy outcome. Results: There was no significant difference in age, duration of infertility, basal FSH value, Gn dosage, number of oocytes retrieved and M II egg rate. 1 Compared with normoxia group, embryos IVF or There was no significant difference in fertilization rate, cleavage rate and high quality embryo formed on the third day after ICSI (P> 0.05), but there was no significant difference between clinical pregnancy rate and implantation rate (P> 0.05) The grade Ⅴ blastocysts formed by IVF or ICSI in oxygen group were more than those in normoxia group (P <0.05), and there was a significant difference (P <0.01) between the rate of total blastocyst formation and clinical pregnancy rate and implantation rate No significant difference between groups (P> 0.05). CONCLUSION: Hypoxic culture does not significantly promote the development of cleavage stage IVF / ICSI embryos, but promotes the development of blastocysts, especially the blastocyst hatching, compared with normoxic culture conditions, so hypoxic culture can As a preferred condition for blastocyst culture, it is not a requirement for cleavage stage embryo culture.