第二极体排出时间早晚与胚胎发育潜能相关性的研究

目的探讨第二极体排出时间早晚与胚胎质量及发育潜能之间的关系。方法以本生殖医学中心2009年6月-8月IVF—ET周期患者受精卵子为研究对象，共计1170枚卵子。以受精5h为时间界限将受精胚胎分为第二极体正常排出组（正常组）和延迟排出组（延迟组）。分别观察两组卵子正常／异常受精率（2PN率，1PN和3PN率）和优质胚胎率；同时统计阳性妊娠结局所移植胚胎中，正常组和延迟组的胚胎比例各占多少。采用卡方检验对数据进行统计学处理。结果①两组正常受精卵数目之间以及异常受精卵数目之间均有显著性差异（P〈0．05）；两组总受精卵数目之间有非常显著差异（P〈0．001）。②两组的优质胚胎率之间显著性差异（P〈0．05）。③统计阳性妊娠结局所移植的97个胚胎中，来自于正常组的胚胎有92个（94．9％），仅5个是来自于延迟组（5．1％）。结论受精5h内排出第二极体的卵子其总受精率、正常受精率以及所发育的胚胎质量均显著高于第二极体出现晚的卵子，而且有着较高的胚胎植入率。对受精5h的卵子进行第二极体观察有助于早期预测患者本次IVF-ET周期胚胎的发育潜能以及妊娠结局；还可以作为决定是否行早补救ICSI的判定指标之一。

Relativity between Extruding Time of Secondary Polar Body and Developing Potential of Embryo

Objective To explore the relativity between the extruding time of secondary polar body and the developing potential of embryo. Methods A total of 1170 oocytes retrieved from patients who accepted the IVF-ET treatment in our reproductive center from June to August in 2009 were observed. The embryos were divided into two groups： normal group （the extruding time of secondary polar body was no more than 5 h after semination） and late group （ extruding time was more than 5 h after semination） . Then several items were observed, including normal/abnormal fertilization （1PN, 2PN and 3PN contained respectively） and high quality embryos. In addition, in the clinical pregnancies, the percentage of transferred embryos from each group was counted respectively. Chi-square test was performed in this experiment. Results （!） There were significant differences in the number of normal fertilized zygotes, abnormal fertilized zygotes and total fertilized zygotes between the two groups respectively, P 〈 0. 05. （1） The number of high quality embryos in the normal group was markedly higher than that in the late group, P 〈 0. 001. （2） Of the 97 transferred embryos of the positive pregnancies, 92 （ 94. 9 % ） were come from the normal group and only 5 （5. 1% ） from the late group. Conclusion The oocytes which extruded the secondary polar body within 5 h after semination are related to the high ratte of total fertilization,normal fertilization,high quality embryos and embryo implantation. Observation of the secondary polar body extrusion within 5 h after semination may benefit to predict developing potential of zygotes and pregnancy out- come of patients in the present IVF-ET cycle. What＇ s more, whether extruding the secondary polar body within 5 h after semination may regard as a considerable indicator to value whether early ICSI is done for patients.