تأثیر یونومایسین به عنوان یک ماده مصنوعی فعال کننده تخمک بر نتایج لقاح پس از انجام تزریق سیتوپلاسمی اسپرم به درون تخمک

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه بافت شناسی و جنین شناسی، گروه علوم تشریح و بیولوژی مولکولی، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

2 پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشیار گروه جنین شناسی، گروه جنین شناسی و آندرولوژی پژوهشکده رویان، مرکز باروری و ناباروری اصفهان، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 مربی گروه بافت شناسی، گروه علوم تشریح، دانشکده پزشکی، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران.

چکیده

مقدمه: جهت افزایش احتمال لقاح در مواردی که عدم موفقیت لقاح بعد از انجام تزریق سیتوپلاسمی اسپرم به درون تخمک (ICSI)، ناشی از فعال نشدن تخمک باشد، فعال کردن تخمک به صورت مصنوعی توصیه می شود. روش های فعال کردن مصنوعی تخمک از طریق استفاده از یک ماده شیمیایی یا به طریق الکتریکی می باشد. مطالعه حاضر با هدف بررسی تأثیر یونومایسین به عنوان یک ماده شیمیایی که به طور مصنوعی باعث فعال سازی تخمک می شود، بر میزان لقاح، تسهیم، رشد و نمو جنین و میزان بارداری بعد از انجام ICSI انجام شد.
روش‌کار: این مطالعه مداخله ای در سال 84-1383 بر روی 87 زوج نابارور مراجعه کننده به مرکز باروری و ناباروری اصفهان که علت ناباروری آنها فاکتورهای مردانه بود، انجام شد. مایع سمن از افراد مورد مطالعه جهت درمان ICSI جمع آوری شد. بخشی از آن جهت آنالیز معمول سمن که شامل بررسی غلظت، تحرک و مورفولوژی است، بر اساس معیارهای سازمان بهداشت جهانی استفاده شد و باقیمانده نمونه ها به روش با Pure Sperm شستشو داده شد و جهت انجام عمل ICSI مورد استفاده قرار گرفت. برای هر بیمار، اووسیت ها به طور تصادفی در دو گروه کنترل و تیمار قرار گرفتند. اووسیت های گروه تیمار به مدت 10 دقیقه در مجاورت با 10 میکرو مولار یونومایسین قرار گرفتند. پس از گذشت 18- 16 ساعت از تزریق به داخل اووسیت، میزان لقاح بر اساس مشاهده پیش هسته ها بررسی شد. میزان تسهیم و کیفیت جنین 48 و 72 ساعت پس از لقاح برای هر دو گروه بررسی و ثبت شد. داده ها پس از گردآوری با استفاده از نرم افزار آماریSPSS (نسخه 5/11) مورد تجزیه و تحلیل قرار گرفت. جهت مقایسه میانگین داده ها بین دو گروه از آزمون تی استفاده شد. میزان pکمتر از 05/0 معنی دار در نظر گرفته شد.
یافته‌ها: بین دو گروه از نظر میزان لقاح و درصد تسهیم 72 ساعت بعد از ICSI تفاوت معنی داری مشاهده شد (001/0>p). به علاوه در بیمارانی که گروه کنترل آنها فاقد لقاح بود، از گروه تیمار با یونومایسین، 2 عدد بارداری به دست آمد. در حالی که در گروهی که میزان لقاح پایین (33-1%) بود، میانگین میزان لقاح در گروه تیمار آنها (31/58%) نسبت به گروه کنترل (3/14%) به طور معنی داری افزایش یافت.
نتیجه‌گیری: فعال سازی مصنوعی تخمک با استفاده از یونومایسین نه تنها بر میزان موفقیت در لقاح، بلکه بر میزان تسهیم و همچنین رشد جنین اثر مثبت دارد.

کلیدواژه‌ها

عنوان مقاله [English]

Effect of Ionomycin as an Artificial Oocyte Activator on Fertilization Outcome by ICSI

نویسندگان [English]

  • Shahnaz Razavi 1
  • Zeinab Javdan 2
  • Mohammad Hossein Nasr Esfahani 3
  • Masoud Sadeghi 4
1 Associate Professor of Histology and Embryology, Department of Anatomy and Molecular Biology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
2 General Practitioner, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Associate Professor of Embryology, Department of Embryology and Andrology of Royan Institute, Fertility and Infertility Center, Isfahan University of Medical Sciences, Isfahan, Iran.
4 Lecturer of Histology, Department of Anatomy, Faculty of Medicine, University of Shahrekord, Shahrekord, Iran
چکیده [English]

Introduction: To increase the likelihood of fertilization in cases of failed oocytes activation after Intracytoplasmic sperm injection (ICSI) due to oocyte lack of activation, artificially activating oocyte is recommended. Artificial oocyte activation methods include: electrical and chemical activation. The aim of this study was to evaluate the efficiency of Ionomycin as a chemical substance that artificially activates oocyte on fertilization,cleavage rate and embryonic development, and pregnancy rates after ICSI was performed.
Methods: This interventional study was held on 87 couples with male factor etiology referring to Fertility and Infertility center for treatment in 2004-2005.Semen sample was collected from participants for ICSI treatment. Routine semen analysis includingexamination of the concentration, motility and morphology, according to World Health Organization criteria, was carried out on part of it. The remaining samples were washed with Pure Sperm method and used to perform ICSI. After oocyte collection, the oocytes were randomly divided into two groups: control and artificial oocyte activation (AOA). The AOA group was chemically activated by exposure to 10μM Ionomycin for 10 minutes. Around 16-18 hours after ICSI, fertilization was assessed by presence of pronuclei. The rate of cleavage and quality of embryo were evaluated and recorded 48 and 72 hours after ICSI .Collected data were analyzed by using statistical software SPSS version 11.5. In order to compare the mean of data between two groups T-test was held.P value less than 0.05 was considered statistically significant.
Results: Two group (AOA and control) hadsignificant differences between mean of fertilization and cleavage rates (P<0.001) 72 hours after ICSI. Also in patients who had no fertilization in their control group of AOA group two pregnancies were recorded. In the group whose participants had poor fertilization rate (1-3%), the mean fertilization rate in the treatment group (58.31%) was significantly increased than the control group (14.3%).
Conclusion: Artificial the oocyte activation using Ionomycin not only improves fertilization but also has positive effect on cleavage rates and embryo quality which in turn affect the implantation and pregnancy rate.

کلیدواژه‌ها [English]

  • Failed fertilization
  • ICSI
  • Ionomycin
  • Oocyte activation

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مجله زنان، مامایی و نازایی ایران
دوره 15، شماره 18 - شماره پیاپی 18
هفته چهارم شهریور ماه 1391
شهریور 1391
صفحه 1-9

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