实用医学杂志 ›› 2022, Vol. 38 ›› Issue (9): 1060-1069.doi: 10.3969/j.issn.1006⁃5725.2022.09.004

• 专题报道 • 上一篇    下一篇

离子霉素辅助卵子激活对卵胞浆内单精子注射后受精失败患者的影响

罗阳1 彭芳2 李磊1 刘文博1 刘寒艳1   

  1.  1 广东省产科重大疾病重点实验室,广东省生殖医学重点实验室,广州医科大学附属第三医院妇产科,生殖医学中心(广州 510150);2 广州医科大学附属第三医院重症医学科(广州 510150)

  • 出版日期:2022-05-10 发布日期:2022-05-10
  • 通讯作者: 刘寒艳 E⁃mail:liuhanyan21@gzhmu.edu.cn
  • 基金资助:
    国家自然科学基金项目(编号:81871211);广东省自然科学基金(编号:2018A030313665);广州市市校联合资助(高水平大学)基础研究项目(编号:202102010055)

Effects of assisted oocyte activation with ionomycin in thepatients with previous fertilization failure after ICSI

LUO Yang*,PENG Fang,LI Lei,LIU Wenbo,LIU Hanyan.   

  1. Department of Obstetrics and Gynecology Center for Reproductive Medicine,Key Laboratory for Major Obstetric Diseases of Guangdong Province,the Third Af⁃ filiated Hospital of Guangzhou Medical University,Guangzhou 510150,China

  • Online:2022-05-10 Published:2022-05-10
  • Contact: LIU Hanyan E⁃mail:liuhanyan21@gzhmu.edu.cn

摘要:

目的 探讨行离子霉素辅助卵子激活(assisted oocyte activation,AOA)对卵胞浆内单精子注 射(intracytoplasmic sperm injection,ICSI)后受精失败患者的影响。方法 回顾性分析 2018 6 月至 2019 10 月在广州医科大学附属第三医院生殖医学中心助孕治疗、因以往 ICSI 受精失败而行离子霉素 AOA 处理的 56 例患者资料,观察 AOA 处理前后的受精情况、胚胎发育及临床结局,并研究 AOA 处理对新生儿 结局的影响。结果 在实施 AOA 之后,患者的受精率和正常受精率均显著提高(P < 0.001),完全受精失 败率和低受精率则显著降低(P < 0.001);第 3 天可利用胚胎率以及优质胚胎率显著增加(P < 0.05);AOA 还显著降低了无可利用胚胎周期率(P < 0.05)。AOA 增加了临床妊娠/活产率,提高了胚胎着床率,以及 累积妊娠/活产率。新生儿结局方面,以同时期进行的常规ICSI 患者的新生儿结局作为对照组,结果发现, 离子霉素处理后新生儿的双胞胎比例、孕周、出生体质量、性别比、早产儿(< 37 周)、大于胎龄儿(> 40 周) 以及低出生体质量(< 2 500 g)同对照组差异均无统计学意义(P > 0.05)。结论 离子霉素能够改善既往 ICSI 后受精失败患者的治疗结局,但更大样本量的研究仍然是必要的,尤其是安全性评估方面。

关键词:

卵胞浆内单精子注射(ICSI), 受精失败, 辅助卵子激活(AOA), 离子霉素, 出生缺陷

Abstract:

Objective To explore the effect of assisted oocyte activation (AOA)with ionomycin in patients with previous fertilization failure after intracytoplasmic sperm injection(ICSI). Methods In this study 56 patients who received ICSI⁃AOA treatment at the Center for Reproductive Medicine of the Third Affiliated Hospital of Guangzhou Medical University were analyzed retrospectively. The fertilization,embryo development clinical outcomes and neonatal outcomes after AOA treatment were observed. Results The fertilization and normal fertiliza⁃ tion rates were significantly increased(P < 0.001)after AOA treatment with ionomycin,while the total fertilization failure and low fertilization rate were significantly reduced(P < 0.001). Interestingly,when compared to the con⁃ trol group,the rate of transferable embryos and good⁃quality embryos on day 3 was significantly higher in the AOA group(P < 0.05). In addition,the AOA group had a significantly higher rate of cycles with no transferable embryo (P < 0.05). Consequently,the rates of clinical pregnancy,implantation,as well as live birth were significantly increased(P < 0.001). In terms of neonatal outcomes,the data derived from conventional ICSI performed at our center during the same time period served as the control group. There were no significant differences in twins,ges⁃ tational weeks,birthweight,gender ratio,preterm birth,large for gestational age,and low birth weight between the two groups(P > 0.05). Conclusions These findings demonstrated that AOA with ionomycin was beneficial for patients who had previously failed fertilization. However,more research with larger groups of couples is needed particularly for safety assessment.

Key words:

intracytoplasmic sperm injection(ICSI), fertilization failure, assisted oocyte activation (AOA), ionomycin, congenital defects