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目的:探讨人卵子体外受精后单原核(PN)和多原核胚胎形成的影响因素,为提高正常受精率探寻可行的方法。方法:回顾性分析1 004个IVF周期和250个ICSI周期,共计15 364个卵细胞资料,研究胚胎原核形成与体外受精方式、女方年龄、生育史、获卵数的关系。结果:①ICSI周期的1PN率明显高于IVF周期,而3PN和4PN形成率则明显低于IVF(P<0.05)。②当女方年龄>35岁时,1PN、3PN和4PN形成率均显著高于年龄≤35岁者(P<0.05);当女方年龄在28￣35岁时2PN(正常受精率)生成率最高(P<0.05),此年龄段的患者施行ICSI时3PN生成率也最高(P<0.05)。③女方无生育史的1PN形成率上明显高于有生育史患者(P<0.05)。④获取6￣10枚卵组,2PN形成率明显高于1￣5枚卵组和>20个卵组(P<0.05);而对于1PN、3PN、4PN形成率,获11￣15枚卵组明显高于其他获卵数组(P<0.05);而在获卵数>20枚时ICSI组2PN(正常受精率)生成率显著降低。结论:人体外受精正常与否受到受精方式、女方年龄、生育史和取卵数目等因素的影响,因此,在进行辅助生殖技术(ART)时应综合考虑这些因素,有助于提高正常受精率,降低异常受精率。
Objective: To explore the factors that influence the formation of single pronucleus (PN) and multiple pronucleus embryos (IVF) after in vitro fertilization (IVF) in human oocytes, and explore possible methods to improve normal fertilization rate. Methods: A total of 1 004 IVF cycles and 250 ICSI cycles were retrospectively analyzed. A total of 15 364 eggs were used to investigate the relationship between embryonic prokaryotic formation and in vitro fertilization, female age, fertility history and number of oocytes retrieved. Results: ① The 1PN rate of ICSI was significantly higher than that of IVF, while the formation rate of 3PN and 4PN was significantly lower than that of IVF (P <0.05). ②When the female was over 35 years of age, the formation rates of 1PN, 3PN and 4PN were significantly higher than those of 35 years of age (P <0.05). The formation rate of 2PN (normal fertilization) was highest when the female was 28-35 P <0.05). The incidence of 3PN was also the highest in patients of this age group (P <0.05). ③ The incidence of 1PN in women without reproductive history was significantly higher than those in reproductive history (P <0.05). ④For 6 ~ 10 eggs, the formation rate of 2PN was significantly higher than that of 1 ~ 5 eggs and> 20 eggs (P <0.05); while the formation rate of 1PN, 3PN and 4PN was 11 ~ 15 eggs (P <0.05). However, the incidence of 2PN (normal fertilization rate) in ICSI group was significantly lower when the number of oocytes was> 20. CONCLUSION: The factors of fertilization, female age, fertility history and the number of oocytes fetuses are affected by normal or not. Therefore, these factors should be taken into consideration when assisted reproductive technology (ART) is taken into account, which is helpful to improve the normal fertilization rate , Reduce abnormal fertilization rate.