摘要目的 探讨人绒毛膜促性腺激素(hCG)注射后不同时间受精对体外受精-胚胎移植(IVF-ET)治疗患者实验室指标及临床指标的影响.方法 选取行IVF-ET治疗并符合纳入标准的患者200例,根据hCG注射后受精时间不同随机分为4组:hCG注射后38.0～39.0 h受精为A组;注射hCG后39.1～40.0 h受精为B组、hCG注射后40.1～41.0h受精为C组、hCG注射后41.1～42.0h受精为D组,每组50例,观察并比较四组间实验室指标及临床指标.结果 可用胚胎率B组(65.7％)、C组(63.3％)、D组(66.8％)均高于A组(55.5％)(P＜0.05);优质胚胎率A组(50.6％)显著低于C组(60.2％)与D组(63.6％)(P＜0.05),B组(54.3％)明显低于D组(P＜0.05);C组获得了较好的临床结局,临床妊娠率(50.0％)和着床率(34.2％)较高,流产率(9.1％)较低.正常受精率、正常卵裂率、临床妊娠率、着床率以及流产率组间比较,差异均无统计学意义(P＞0.05).结论 在一定时间范围内(38.0～42.0 h),随着hCG注射后受精时间的延长,优质胚胎率呈增高趋势;本中心IVF-ET治疗患者的最佳受精时间为hCG注射后40.1～41.0 h,此时受精患者有较高的临床妊娠率,较低的早期流产率及较好的临床妊娠结局.

abstractsObjective To investigate the effect of the different fertilization time after human chorionic gonadotropin (hCG) injection on the early embryonic development and clinical outcome of patients during in vitro fertilization-embryo transfer (IVF-ET).Methods A total of 200 patients undergoing IVF-ET were devided into 4 groups according to the different fertilization time after hCG injection.Group A:fertilization happened in 38.0-39.0 h after hCG injection,group B:39.1-40.0 h after hCG injection,group C:40.1-41.0 h after hCG injection,group D:41.1-42.0 h after hCG injection,50 cases in each group.The normal fertilization rate,cleavage rate,the high quality embryo rate,the embryo utilization rate,the clinical pregnancy rate,the implantation rate,and the spontaneous abortion rate were evaluated among the 4 groups.Results The embryo utiliazation rate in group B (65.7％),group C (63.3％),group D (66.8％) was higher than that of group A (55.5％) (P＜0.05).High-quality embryo rate in group A (50.6％) was lower than that of group C (60.2％) and group D (63.6％),while high-quality embryo rate in group B (54.3％) was lower than that in group D (P＜0.05);if fertilization happened in 40.1-41.0 h (including 41 h)after hCG injection,clinical performance was the best [higher clinical pregnancy rate (50.0％) and implantation rate (34.2％)than others,lower abortion rate (9.1％) than others)].There were no obvious differences in the normal fertilization rate,the normal cleavage rate,the clinical pregnancy rate,the implantation rate and the abortion rate among the 4 groups (P＞0.05).Conclusion The different fertilization time after hCG injection in IVF-ET have effects on high-quality embryo rate.During a certain time range (38-42 h),as the increase of delayed fertilization time after hCG injection,highquality embryo rate is also increasing.The best fertilization time of patients in IVF-ET was 40.1-41.0 h after hCG injection in our reproductive center,which can improve the clinical pregnancy rate,reduce the early abortion rate and get better clinical pregnancy outcome.