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目的:探讨低氧环境(体积分数5%O2)对体外受精-胚胎移植(in vitro fertilization-em-bryo transfer,IVF-ET)中胚胎发育潜能及临床结局的影响。方法:将接受IVF-ET长方案治疗的265名不孕症患者随机分为研究组(n=156):患者取卵后受精及整个胚胎培养过程全部在三气培养箱(体积分数5%O2)中进行,对照组(n=109):患者取卵后受精及整个胚胎培养过程全部在常规培养箱(体积分数20%O2)内进行,所有患者均移植授精第2日或第3日胚胎。比较组间受精率、正常受精率、卵裂率、正常卵裂率、优质胚胎率、可用胚胎率、生化妊娠率、临床妊娠率和异位妊娠率。结果:组间患者年龄、不孕年限、体质量指数、基础性激素、获卵数、成熟卵数、授精至移植时间和移植胚胎数均无统计学差异(P>0.05)。研究组受精率(84.4%)、正常受精率(72.0%)、卵裂率(97.6%)、优质胚胎率(43.3%)和可用胚胎率(72.5%)均显著高于对照组(分别为80.8%、68.7%、96.1%、35.1%、59.5%)(P<0.01或P<0.05),研究组与对照组正常卵裂率(97.7%vs 98.0%)、生化妊娠率(50.0%vs 39.4%)、临床妊娠率(44.9%vs 35.8%)、异位妊娠率(8.6%vs 12.8%)均无统计学差异(P>0.05)。结论:低氧环境(5%O2)似乎能够提高胚胎的发育潜能,获得更多优质胚胎和可用胚胎。
Objective: To investigate the effect of hypoxia (5% O2) on embryonic developmental potential and clinical outcome in in vitro fertilization-embryo transfer (IVF-ET). METHODS: A total of 265 infertile patients treated with the IVF-ET regimen were randomly assigned to study group (n = 156): All patients were fertilized and the entire embryo culture was performed in a three-gas incubator (5% O2 ). The control group (n = 109): all patients were fertilized on day 2 or day 3 after fertilization and the entire embryo culture was performed in a conventional incubator (volume fraction 20% O2) . The fertilization rate, normal fertilization rate, cleavage rate, normal cleavage rate, high quality embryo rate, available embryo rate, biochemical pregnancy rate, clinical pregnancy rate and ectopic pregnancy rate were compared. Results: There was no significant difference in age, duration of infertility, body mass index, basic hormone, number of oocytes retrieved, number of mature eggs, time between fertilization and transplantation and number of embryos transferred (P> 0.05). The fertilization rate (84.4%), normal fertilization rate (72.0%), cleavage rate (97.6%), high quality embryo rate (43.3%) and available embryo rate (72.5%) were significantly higher in the study group than those in the control group The normal cleavage rate (97.7% vs 98.0%), the biochemical pregnancy rate (50.0% vs 39.4%) in the study group and the control group were significantly higher than those in the control group (68.7%, 96.1%, 35.1%, 59.5% ), Clinical pregnancy rate (44.9% vs 35.8%), ectopic pregnancy rate (8.6% vs 12.8%) had no statistical difference (P> 0.05). CONCLUSIONS: Hypoxic environment (5% O2) appears to improve embryonic developmental potential, gaining more quality embryos and available embryos.