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目的分析短时受精后观察第二极体及受精失败后早补救ICSI在体外受精-胚胎移植中的应用价值。方法回顾分析本中心2013年1月—2015年5月第一次行常规IVF-ET治疗周期的患者资料,根据受精后3h是否剥除颗粒细胞观察第二极体分为第二极体观察组(605例),非第二极体观察组(217例),分析两组的数据;并对比受精失败组与同期ICSI周期的数据进行分析。结果 1)短时受精后第二极体观察对正常受精率、多精受精率、优质胚胎率及临床妊娠率无明显影响(P>0.05),2)受精失败组的基础LH水平、成熟卵率明显低于正常受精组(P<0.05),3)对比低受精组、完全受精失败组与常规ICSI周期,分析后发现完全受精失败组的成熟卵率及优质胚胎率均明显低于低受精失败组和常规ICSI组(P<0.05),正常受精率和临床妊娠率无统计学差异。结论短时受精后剥除颗粒细胞观察第二极体联合补救ICSI能有效的避免受精失败并减少ICSI率,患者的基础LH水平及获卵的成熟度可能会影响受精及胚胎的发育。
Objective To analyze the value of early recovery ICSI after IVF and fertilization failure after short-term fertilization in in vitro fertilization-embryo transfer. Methods The data of patients who underwent IVF-ET for the first time from January 2013 to May 2015 in our center were retrospectively analyzed. According to whether the cells were removed 3 hours after fertilization, the second polar body was divided into the second polar body observation group (605 cases) and non-polar body observation group (217 cases). The data of two groups were analyzed. The data of failed fertilization group and ICSI period were also analyzed. Results 1) The observation of the second polar body after short-term fertilization had no significant effect on normal fertilization rate, fertilization rate, high quality embryo rate and clinical pregnancy rate (P> 0.05), 2) basal LH level, fertilized egg (P <0.05). 3) Compared with low fertilization group, complete fertilization failure group and routine ICSI cycle, the results of analysis showed that the mature fertilization rate and high quality embryo rate of the complete fertilization failure group were significantly lower than those of the low fertilization Failed group and routine ICSI group (P <0.05), normal fertilization rate and clinical pregnancy rate was no significant difference. Conclusion Observing the combination of second polar body and ICSI with shortened granulosa cells after short-term fertilization can effectively avoid the failure of fertilization and reduce the ICSI rate. Patients’ basal LH level and ovipositing maturity may affect fertilization and embryo development.