摘要
目的探讨注射人绒毛膜促性腺激素(HCG)后不同受精时机对短时体外受精(IVF)妊娠结局的影响。方法回顾分析585例接受短时IVF助孕患者的临床资料,共585个周期,其中HCG后38 h组292个周期(292例),HCG后40 h组293个周期(293例)。两组均采用第一周期长效长方案进行促排卵治疗,行超声引导下经阴道穿刺取卵术,卵细胞与精液处理完成后实施IVF,HCG后40 h组患者在注射HCG后40 h行短时受精,HCG后38 h组患者在注射HCG后38 h行短时受精。比较两组受精情况、妊娠情况及妊娠结局。结果HCG后40 h组正常受精率92.57%、优质胚胎率54.01%均显著高于HCG后38 h组的85.57%、40.20%,异常受精率7.43%、早期补救卵胞浆内单精子注射(ICSI)率3.04%显著低于HCG后38 h组的14.43%、10.57%,差异具有统计学意义(P<0.05)。HCG后40 h组胚胎着床率64.95%、临床妊娠率49.49%均显著高于HCG后38 h组的48.42%、38.01%,差异具有统计学意义(P<0.05);HCG后40 h组临床妊娠患者的早期流产率8.97%显著低于HCG后38 h组的29.73%,差异具有统计学意义(P<0.05)。结论注射HCG后38 h行短时受精结局差于注射HCG后40 h,尤其是早期补救ICSI比例有所上升,应优先考虑注射HCG后40 h受精,以改善受精效果,提高临床妊娠率,并改善患者妊娠结局。
Objective To discuss the effect of different timing of fertilization after human chorionic gonadotropin(HCG)injection on short-time in vitro fertilization(IVF)pregnancy outcome.Methods The clinical data of 585 patients who received short-time IVF assisted pregnancy were retrospectively analyzed.A total of 585 cycles were performed,including 292 cycles in the 38 h post-HCG group(292 cases)and 293 cycles in the 40 h post-HCG group(293 cases).Both groups were treated with the first cycle of long-acting long protocol for ovulation induction,ultrasound-guided transvaginal puncture was performed for egg retrieval,and IVF was performed after completion of oocyte and semen processing.Patients in the 40 h post-HCG group underwent short-time fertilization 40 h after HCG injection,and patients in the 38 h post-HCG group underwent shorttime fertilization 38 h after HCG injection.Both groups were compared for fertilization,pregnancy and pregnancy outcome.Results The normal fertilization rate 92.57%and high-quality embryo rate 54.01%in the 40 h postHCG group were significantly higher than 85.57%and 40.20%in the 38 h post-HCG group;the abnormal fertilization rate 7.43%and early remedial intracytoplasmic single sperm injection(ICSI)rate 3.04%in the 40 h post-HCG group were significantly lower than 14.43%and 10.57%in the 38-h post-HCG group;the differences were statistically significant(P<0.05).The embryo implantation rate 64.95%and clinical pregnancy rate 49.49%in the 40 h post-HCG group were significantly higher than 48.42%and 38.01%in the 38 h post-HCG group,and the differences were statistically significant(P<0.05).The early abortion rate of clinically pregnant patients 8.97%in the 40 h post-HCG group was significantly lower than 29.73%in the 38 h post-HCG group,and the difference was statistically significant(P<0.05).Conclusion Short-time fertilization outcome at 38 h after HCG injection is worse than that at 40 h after HCG injection,especially when the proportion of early remedial ICSI has increased,and fertilization at 40 h after HCG injection should be prioritized to improve fertilization outcome,increase clinical pregnancy rate,and improve pregnancy outcome of patients.
作者
高松城
王惠洁
黄智勇
GAO Song-cheng;WANG Hui-jie;HUANG Zhi-yong(Reproductive Medicine Center,Shaoguan Maternal and Child Health Hospital,Shaoguan 512026,China)
出处
《中国现代药物应用》
2022年第24期54-56,共3页
Chinese Journal of Modern Drug Application
关键词
注射人绒毛膜促性腺激素
受精时机
短时体外受精
妊娠结局
优质胚胎
Human chorionic gonadotropin for injection
Timing of fertilization
Short-time in vitro fertilization
Pregnancy outcome
High-quality embryo
