CAJ | 학술논문

目的：通过检测洗精培养液和受精培养液中活性氧的关系，探讨精卵孵育不同时间对体外受精-胚胎移植（IVF-ET）结局的影响。方法接受常规体外受精（IVF）受精的夫妇161例，精液经处理后留取标本（即洗精培养液）3份，分别定为加精后0h、5h和20h检测过氧化氢（H2O2）、过氧化氢酶（CTA）。每名患者取出的卵冠丘复合物（OCCCs）随机分为两组：A组为短时受精，B组为长时受精，检测移卵后的受精培养液中H2O2、CTA的含量。移植的123名患者随机分成两组，一组62人选择短时受精的胚胎进行移植，另一组61人选择长时受精的胚胎进行移植。结果 H2O2及CTA水平在授精后5h明显与A组呈正相关（r值分别为0.477和0.518，P＜0.05），在授精后20h与B组呈明显正相关（r值分别为0.681和0.868，P＜0.05）。授精后5h及授精后20h的洗精培养液中H2O2水平均明显高于相应时间的受精培养液（P＜0.05），而CTA水平只在授精后5h明显低于A组的受精培养液（P＜0.05），在授精后20h与B组之间没有明显差异（P＞0.05）。B组的多精受精率明显高于A组（P＜0.05），A组的优胚率明显高于B组（P＜0.05），两组间的受精率、卵裂率、植入率、临床妊娠率无统计学差异。结论缩短精卵孵育时间可以使卵子尽早脱离高活性氧的环境，有利于胚胎的发育。
목적：통과검측세정배양액화수정배양액중활성양적관계，탐토정란부육불동시간대체외수정-배태이식（IVF-ET）결국적영향。방법접수상규체외수정（IVF）수정적부부161례，정액경처리후류취표본（즉세정배양액）3빈，분별정위가정후0h、5h화20h검측과양화경（H2O2）、과양화경매（CTA）。매명환자취출적란관구복합물（OCCCs）수궤분위량조：A조위단시수정，B조위장시수정，검측이란후적수정배양액중H2O2、CTA적함량。이식적123명환자수궤분성량조，일조62인선택단시수정적배태진행이식，령일조61인선택장시수정적배태진행이식。결과 H2O2급CTA수평재수정후5h명현여A조정정상관（r치분별위0.477화0.518，P＜0.05），재수정후20h여B조정명현정상관（r치분별위0.681화0.868，P＜0.05）。수정후5h급수정후20h적세정배양액중H2O2수평균명현고우상응시간적수정배양액（P＜0.05），이CTA수평지재수정후5h명현저우A조적수정배양액（P＜0.05），재수정후20h여B조지간몰유명현차이（P＞0.05）。B조적다정수정솔명현고우A조（P＜0.05），A조적우배솔명현고우B조（P＜0.05），량조간적수정솔、란렬솔、식입솔、림상임신솔무통계학차이。결론축단정란부육시간가이사란자진조탈리고활성양적배경，유리우배태적발육。
Objective To analyze the relationship of reactive oxygen species between the sperm wash medium and insemination medium, and explore the effect of different incubation time on the outcome of in vitro fertilization and embryo transfer. Methods One hundred and sixty-one patients who underwent in vitro fertilization and embryo transfer for female infertility were recruited in the study. Three samples were collected after the semen of patients was pretreated with Pure Sperm. Each was defined as 0h after insemination, 5h after insemination and 20h after insemination to detect of the content of H2O2 and CTA. On the oocyte retrieval day, the OCCCs which retrieved from the same patient were divided into short-term fertilization group (group A) and long-term fertilization group (group B) according to incubation time. The concentrations of H2O2 and CTA in insemination medium were detected respectively. On the embryo transfer day,the patients were divided into two groups: one group of patients chose short-term fertilized embryo to transfer, one group of patients chose long fertilized embryo to transfer. Results The levels of hydrogen peroxide and catalase at 5h after insemination were positively correlated with those of group A(r=0.477, 0.518, P<0.05), and the levels of hydrogen peroxide and catalase at 20h after insemination were positively correlated with those of group B(r=0.681, 0.868, P<0.05). The levels of hydrogen peroxide at 5h, 20h after insemination were corresponding higher than that in the insemination medium of group A and group B significantly (P<0.05). The levels of catalase at 5h after insemination were lower than those in the insemination medium of group A significantly (P<0.05), but the levels of catalase at 20h after insemination had no difference with those in the insemination medium of group B(P>0.05). The polyspermy rate in group B was significantly higher than that in group A(P<0.05), and the high quality embryo rate in group A was significantly higher than that in group B(P<0.05). There were significant difference in fertilization rate, cleavage rate, implantation rate, clinical pregnancy rate between the two groups (P>0.05). Conclusion Shorten the incubation time of oocytes and spermcould protect oocytes from the high reactive oxygen environment so as to improve the quality of embryos.