论文部分内容阅读
目的:探讨女性不同病因对卵母细胞透明带、胚胎发育和妊娠结局等的影响。方法:回顾性分析因单因素不孕体外受精治疗的197个周期,以输卵管因素为对照组(n=145),比较多囊卵巢综合征(polycystic ovarian syndrome,PCOS)(n=25)、子宫内膜异位症(endometriosis,EMs)(n=19)和不明原因不孕症(n=8)等各组的受精率、种植率、妊娠率以及透明带双折射性和透明带厚度。结果:平均获卵数PCOS组(17.9±1.9枚)显著高于其它各组(对照组:11.3±0.6枚,EMs组:9.4±1.2枚和不明原因组:13.1±2.9)(P<0.01),其它各组无统计学差异(P>0.05);PCOS组、EMs组和不明原因组受精率(83.66%、75.40%、77.12%)、优质胚胎率(57.26%、51.14%、59.30%)、种植率(25.53%、17.39%、29.40%)和妊娠率(52.38%、41.18%、42.86%)与对照组(80.13%、58.99%、28.76%、43.70%)间无统计学差异(P>0.05),但EMs组各项指标均低于对照组。透明带双折射值各组间差异极显著(对照组:7.13±0.28,PCOS组:4.97±0.55,EMs组:3.67±0.75,不明原因组:14.19±1.41)(P<0.01),其中EMs组透明带双折射值最低。受精当日透明带厚度EMs组显著高于其它各组(对照组:18.84±0.07,PCOS组:18.48±0.17,EMs组:19.75±0.24,不明原因组:18.98±0.26)。结论:EMs对受精率、妊娠率和透明带双折射值等的影响最明显,透明带的双折射值和厚度可在一定程度上反映不同病因对卵母细胞发育潜力的影响。
Objective: To investigate the effects of different causes of female on zona pellucida, embryonic development and pregnancy outcome. Methods: A total of 197 cycles of in vitro fertilization with single factor infertility were retrospectively analyzed. Tubal factors were used as the control group (n = 145). Polycystic ovarian syndrome (PCOS) (n = 25) The fertilization rate, implantation rate, pregnancy rate and zona pellucida birefringence and zona pellucida thickness of endometriosis (EMs) (n = 19) and unexplained infertility (n = 8) Results: The mean number of oocytes retrieved in PCOS group was significantly higher than that in other groups (11.3 ± 0.6 in control group, 9.4 ± 1.2 in EMs group and 13.1 ± 2.9 in unexplained group) (P <0.01) (P> 0.05). The rates of fertilization (83.66%, 75.40%, 77.12%), high quality embryos (57.26%, 51.14%, 59.30%) in PCOS group, EMs group and unexplained group were significantly higher than those in control group There was no significant difference between the two groups in implantation rate (25.53%, 17.39%, 29.40%) and pregnancy rate (52.38%, 41.18%, 42.86%) and control group (80.13%, 58.99%, 28.76%, 43.70% ), But the EMs group indicators were lower than the control group. The birefringence of zona pellucida was significantly different among groups (control group: 7.13 ± 0.28, PCOS group: 4.97 ± 0.55, EMs group: 3.67 ± 0.75, unexplained group: 14.19 ± 1.41) (P <0.01) Transparent band birefringence lowest. The thickness of zona pellucida in EMs group on the day of fertilization was significantly higher than that of other groups (control group: 18.84 ± 0.07, PCOS group: 18.48 ± 0.17, EMs group: 19.75 ± 0.24, unexplained group: 18.98 ± 0.26). CONCLUSIONS: The effects of EMs on fertilization rate, pregnancy rate and birefringence of zona pellucida are the most obvious. The birefringence value and thickness of zona pellucida can reflect the influence of different etiologies on the developmental potential of oocytes.