| Objective: The occurrence of multi-nucleated zygotes in the in vitro fertilization-embryo transfer(IVF-ET) is about 2% to 12%. Although such abnormal zygotes can develop to embryos in some extent, they lead to high tendency of miscarriage,hydatidiform mole and oafs due to polyploid in the end. As a result, the multi-nucleated zygotes can not be transferred which will decrease the utilizing efficiency of oocytes and the number of good embryoes. Our study devided patients to two groups on the basis of whether there were multi-nucleated zygotes formulated or not in the treatment of IVF,then compared multiple parameters of the two groups to discuss which factors may be related to this abnormal phenomenon and its effects to the clinical pregnancy. The studied parameters in this research mainly include three proportions: clinical factors,such as females'age,the main cause of infertility,the ovulation protocols,the number of gonadotropin(Gn) ampoules used,the number of days of gonadotropin used,the peak estradiol,the level of progesterone and luteinizing hormone (LH)on the day of human chorionic gonadotrop (HCG) administrated,the number of occytes retrieved and the basic state of the semen quality ; laborotary facotors: the number of can-be-used embryoes,the rate of can-be-used embryoes and the normal fertilization rate;datas pertinent to clinical pregnancy: implantation rates,pregnancy rates and abortion rates.Methods: A retrospective study of 867 IVF cycles was carried out from the center of Reproductive Medicine of the second hospital of Hebei Medical University from January 2007 to June 2009. Cycles were divided into two groups: group A, cycles with one or more multi-nucleated zygotes after IVF, and group B, cycles with no multi-nucleated zygotes. Age, amount of gonadotropin administered, peak estradiol levels, number of oocytes retrieved , sperm quality, percentage of diploid zygotes, and implantation rates. pregnancy rates,abortion rates and something else were compared between groups.Result:(1) Compared with patients in group B, those in group A has a lower average age (30.09±4.13 vs 31.04±4.19, t=-3.085, P <0.01),received significantly fewer ampoules of gonadotropins(31.98±12.82 vs 35.84±15.75, t=-3.798,P<0.01), had higher estradiol levels (2911.51±1088.73 vs 2474.43±1169.76 pg/ml, t=5.322,P < 0.01), had higher progesterone levels (1.70±0.84vs1.55±0.85 ng/ml,t=2.438,P<0.05),and had more oocytes retrieved(14.60±7.50vs10.18±6.28,t=8.410,P<0.01).However, years of infertility (4.46±3.43 y vs 4.70±3.23 y), days of gonadotropin used(9.16±2.10d vs 8.94±2.09d),the basic quality of sperm(χ2=2.292, P=0.130) and the LH level on the day of HCG administrated(3.04±2.72 vs 3.33±2.67)IU/L did not differ between groups.(2) The number of can-be-used embryos in group A and group B were(5.42±4.18 vs 7.87±5.77), The rate of can-be-used embryos were(52.41±22.93)% vs 56.75±25.82)%,and the normal fertilization rate were(77.35±19.03)% vs (86.13±25.51)%. Among such comparison,the differences of the number of can-be-used embryos (t=6.254) and the normal fertilization rate (t=-5.618)between the two groups made sense statisticly( P<0.01).Besides, The rate of can-be-used embryos in groupA is lower significantly than group B( t=-2.471,P<0.05).(3) The mean number of implanted embryos in group A and group B were 2.2±0.49 and 2.19±0.55(t=0.221, P=0.825);the pregnancy rates were 33.71% and 35.50%,(χ2=0.261, P=0.609);the abortion rates were 16.48% and 19.00%(χ2=0.070, P=0.791).The distinctions of all those aspects in the two groups did not sound convinctively in statistic.Conclusion:(1) Patients who produced multinucleated zygotes (group A) after IVF were younger,used fewer ampoules of gonadotropins ,and had higher estradiol levels ,progesterone levels on the day of HCG administrated than patients whose zygotes were all diploid zygotes (group B). So the development of multiploid zygotes maybe relates to patients'younger age and their high repondsive ability to ovarian stimulation .(2) The number of can-be-used embryos,the rate of can-be-used embryos and the normal fertilization rate in group A were all lower than group B,which indicates that the appearance of multiploid zygotes brings no benefit to patients but decreasing the chance of electing high-quality embryos which affect the ultimate clinical pregnance significantly.(3) The mean number of implanted embryos,the abortion rates and the pregnancy rates did not differ between groups as factors pertinent to pregnancy and abortion are complex and manifold . |
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