卵胞浆内单精子显微注射受精失败的原因及对策

doi:10.3969/j.issn.2095-4344.2015.51.026

摘要/Abstract

摘要：

背景：卵胞浆内单精子显微注射(ICSI)已经成为治疗男性因素不育的首选方法，且具有很高的成功率，但卵胞浆内单精子显微注射周期的受精失败发生率仍有1%-3%。
目的：简要综述有关卵胞浆内单精子显微注射受精失败的相关因素及其对策。
方法：检索万方数据库、中国知网及PubMed1994年1月至2015年6月与卵胞浆内单精子注射相关研究的文献。阅读文题和摘要，依据纳入排除标准对其中的60篇进行分析探讨。
结果与结论：目前，研究发现卵母细胞激活失败与卵子异常、精子缺陷、患者年龄、显微操作技术及实验室环境等因素密切相关。辅助卵母细胞激活是解决卵胞浆内单精子显微注射后激活失败的关键技术。了解卵胞浆内单精子显微注射受精失败的相关因素后对其采取相应的对策，可以提高卵胞浆内单精子显微注射受精率及改善胚胎发育潜能。

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 组织构建, 组织工程, 卵胞浆内单精子注射, 受精失败, 人工激活

Abstract:

BACKGROUND: Intracytoplasmic sperm injection (ICSI) has become the first choice for treatment of male infertility. Despite its high success rates, fertilization failure following ICSI still occurs in 1%-3% of couples.
OBJECTIVE: To review the relevant factors and countermeasures of fertilization failure in ICSI.
METHODS: Wanfang, CNKI and PubMed databases were searched for articles related to ICSI published from January 1994 to June 2015. Finally, 60 articles meeting the inclusive criteria were included in result analysis.
RESULTS AND CONCLUSION: Oocyte activation failure is closely related to abnormal eggs, sperm defects, age, micromanipulation technology and laboratory environment. Assisted oocyte activation is the gordian technique to solve the fertilization failure in ICSI. To understand the reasons for fertilization failure in ICSI and to take appropriate measures can promote the rate of fertilization and improve the potential of embryonic development.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

中图分类号:

R318

唐永梅，韦继红. 卵胞浆内单精子显微注射受精失败的原因及对策[J]. 中国组织工程研究, 2015, 19(51): 8344-8351.

Tang Yong-mei, Wei Ji-hong. Fertilization failure following intracytoplasmic sperm injection: causes and countermeasures[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(51): 8344-8351.

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引言

受精是使配子的单倍体恢复合子的双倍体,完成种属延续确保物种遗传性和个体发生变异并通过生殖细胞遗传下去的重要的过程，具有生物的进化意义。在受精过程中精子诱导卵母细胞活化是细胞生物学中最基本最引人关注的现象之一。随着人类辅助生殖技术(assisted reproductive techniques，ART)技术的发展，常规体外受精(IVF)已经可以满足大部分患者的需求，但是仍然有患者在一个周期中出现卵母细胞不受精的现象称为完全受精失败[1]。
卵胞浆内单精子显微注射(ICSI)是借助显微注射仪直接将精子注射到卵胞浆内，绕过了常规体外受精(IVF)精子与卵透明带的结合、顶体反应、精子与卵细胞膜的融合等来实现受精的过程。1992年，Palermo等[2]首先报道卵胞浆内单精子显微注射辅助受精获得试管婴儿的出生，该项技术已成为治疗男性不育的理想手段。理论上卵胞浆内单精子显微注射的受精率应为100%，而实际研究其受精率仅为70%左右，因此仍然有30%的卵母细胞仍不受精。其原因可能是因为卵母细胞未能激活，因为卵胞浆内单精子显微注射只能使精子进入卵母细胞，但精子若不能激活卵子，使第二极体排出、DNA去紧密化、原核的形成等后序的变化则会造成受精失败。在目前接受卵胞浆内单精子显微注射治疗的患者中，有1%-3%的患者不能获得受精卵而无法获得可移植胚胎，即卵胞浆内单精子显微注射周期的受精失败发生率为1%-3%[3]。
受精是一个十分复杂的过程，除精子必须具备活力和受精能力、卵子必须达到成熟外，还必须有一定的外界条件。文章将有关卵胞浆内单精子显微注射受精失败的相关因素及其对策作一简要综述。

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程