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目的:比较IVF-ET治疗中精卵孵育不同时间对胚胎质量及治疗结局的影响。方法:189个IVF-ET周期按精卵共孵育时间不同分为短时受精组(A组,精卵共孵育2h)和传统受精组(B组,精卵孵育过夜)。两组中又根据男方精液质量是否正常分为精液正常组和精液异常组(中重度精液异常),分别比较4组的受精率、多精受精率、卵裂率、优质胚胎率、妊娠率、胚胎种植率和流产率。结果:①4组的受精率、多精受精率、卵裂率和流产率差异无统计学意义(P>0.05)。②短时受精组的优质胚胎率、临床妊娠率和胚胎种植率显著高于传统受精组(P分别<0.05、<0.01)。③短时受精中精液正常组(A1组)与精液异常组(A2组)的优质胚胎率、临床妊娠率及胚胎种植率均高于传统受精中的精液异常组(B2组,P分别<0.01或<0.05),而与传统受精中的精液正常组(B1组)比较差异均无统计学意义(P>0.05)。结论:①短时受精不影响受精率、卵裂率和流产率,可提高优质胚胎率、临床妊娠率及胚胎种植率;②短时受精不减少多精受精率;③短时受精对精液质量异常(中重度精液异常)周期治疗结果明显改善。
OBJECTIVE: To compare the effects of different incubation times on embryo quality and outcome in IVF-ET treatment. Methods: 189 IVF-ET cycles were divided into short-term fertilization group (group A, sperm incubation 2h) and traditional fertilization group (group B, overnight incubation of sperm-egg) according to the time of incubation. Two groups were also divided into sperm normal group and semen abnormal group (moderate to severe semen abnormality) according to whether the male’s semen quality was normal or not. The fertilization rate, fertilization rate, cleavage rate, quality embryo rate, pregnancy rate, Embryo implantation rate and abortion rate. Results: ①The fertilization rate, fertilization rate, cleavage rate and miscarriage rate in group 4 were not significantly different (P> 0.05). ② The quality embryo rate, clinical pregnancy rate and embryo implantation rate in short-term fertilization group were significantly higher than those in conventional fertilization group (P <0.05, <0.01 respectively). ③ The quality embryo rate, clinical pregnancy rate and embryo implantation rate of sperm normal group (group A1) and sperm abnormal group (group A2) in short-term fertilization were higher than those in the conventional fertilization group (group B2, P <0.01 Or <0.05). However, there was no significant difference between the normal fertilization group and normal control group (B1 group) (P> 0.05). Conclusion: ①Short-term fertilization does not affect the fertilization rate, cleavage rate and abortion rate, can improve the quality of embryos, clinical pregnancy rate and embryo implantation rate; ② short-term fertilization does not reduce the fertilization rate; ③ short-term fertilization of seminal fluid quality Abnormal (moderate to severe semen abnormalities) cycle treatment results significantly improved.