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1.
目的:比较分析同周期同胞卵分别实施常规体外受精(IVF)和卵胞浆内单精子注射(ICSI)的结果和临床预后. 方法:选择我中心实施体外受精-胚胎移植中的43个治疗周期,将同周期同胞卵分成IVF组和ICSI组,使用相同的精液标本分别实施IVF和ICSI (IVF ICSI), 进行比较分析. 结果:ICSI组受精率为64.5%, 高于IVF组52.8%的受精率(P<0.01); 完全受精失败的IVF组占11.6%, 而ICSI组无一例完全受精失败; ICSI组的优良胚胎率为60.8%, 显著高于IVF组30.1% (P<0.01); 卵裂率分别为97.1%和96.7%, 无统计学意义(P>0.05);用于移植的胚胎数ICSI组为120个占总移植胚胎数的63.5%, IVF组为69个占36.5%; IVF ICSI总的植入率17.5%, 显著高于同期单纯实施IVF 10.4%和单纯实施ICSI 9.8%(P<0.01);取卵周期临床妊娠率同我中心同期单纯实施IVF和单纯实施ICSI比较, 具有统计学意义(P<0.01), 分别为41.9%, 26.2%和28.1%; 抱婴回家率为77.8%. 结论:同周期同胞卵分别实施常规IVF和ICSI总体上能改善胚胎质量增加受孕机会并提高临床妊娠率.  相似文献   

2.
目的 探讨对常规体外受精(IVF)不受精或低受精的病例行补救卵胞浆内单精子注射(ICSI)的临床价值.方法 回顾性分析2008年11月~2009年5月在华中科技大学同济医学院附属同济医院生殖医学中心接受常规IVF治疗的98例非男性因素不孕患者,授精后4~6 h根据第二极体判断卵母细胞受精情况,若卵母细胞完全未受精或受精率低于25%,立即行补救ICSI再受精.结果 在98个常规IVF不受精或低受精周期中,共有卵母细胞1 013个,其中MⅡ期卵840个,经补救ICSI后共受精584个,受精率为69.5%,卵裂率为96.7%,形成可移植胚胎共288个.在86个新鲜移植周期共有32例临床妊娠,妊娠率为37.2%;在9个冷冻复苏移植周期中,有5例临床妊娠,妊娠率为55.5%.结论 常规IVF失败后补救ICSI再受精是可行的,合理的补救时间是获得理想的临床结局的关键.  相似文献   

3.
目的 探讨体外受精(IVF)失败患者后续性治疗时行部分卵胞浆内单精子显微注射(half-ICSI)以及 ICSI 治疗的结局差异.方法 回顾性分析在我中心进行辅助生殖技术,选取前次 IVF受精失败(包括完全受精失败和受精低下即受精率为 0 和低于 25%),在随后周期中行 half- ICSI 治疗的 8 个周期作为研究组(后续性 half-ICSI组),同时因前次 IVF 受精失败在随后治疗周期采取全部卵行 ICSI 方法受精的16个周期(后续性 ICSI 组)的治疗结局作为对照组.结果 后续性 half-ICSI 组总的受精率显著低于后续性 ICSI 组(51.79% vs 67.81%,P<0.01),后续性half-ICSI 组卵裂率、优胚率、植入率、妊娠率、流产率与后续性 ICSI 组相比均差异无统计学意义.妊娠率两组分别为 50%、25.0%,流产率分别为0、6.2%.后续 half-ICSI 组中 IVF 受精率显著低于 ICSI 的受精率(29.82% vs 74.55%)(P<0.001).结论 IVF 受精失败将影响后续性 IVF 治疗的受精率,但是 IVF受精失败并不是 ICSI 治疗的绝对指征,考虑到安全性,half-ICSI 治疗优于ICSI 治疗.  相似文献   

4.
目的:探讨体外受精(IVF)失败患者后续性治疗时行部分卵胞浆内单精子显微注射(half-ICSI)以及ICSI治疗的结局差异。 方法:回顾性分析2007年1月—2009年l2月在我中心进行辅助生殖技术,选取前次IVF受精失败(包括完全受精失败和受精低下,即受精率为0和低于25%),在随后周期中行Half-ICSI治疗的8个周期作为研究组,简称后续性half-ICSI组,同时因前次IVF受精失败在随后治疗周期采取全部卵行ICSI方法受精的16个周期(后续性ICSI组)的治疗结局作为对照组。 结果: 后续性half-ICSI组总的受精率显著低于后续性ICSI组(51.79% vs 67.81%,P<0.01),后续性half-ICSI组卵裂率,优胚率,植入率,妊娠率,流产率与后续性ICSI组相比均无显著性差异。妊娠率两组分别为50%,25.0%,流产率分别为0,6.2%。后续Half-ICSI组中IVF受精率显著低于ICSI的受精率(29.82% vs 74.55%) (P<0.001)。结论: IVF受精失败将影响后续性IVF治疗的受精率,但是IVF受精失败并不是ICSI治疗的绝对指征,考虑到安全性,Half-ICSI治疗优于ICSI治疗。  相似文献   

5.
目的: 通过分析体外受精-胚胎移植周期中,非男性因素的卵巢反应不良患者受精情况及临床结局,探讨这类患者合适的受精方式。方法:回顾性分析体外受精胚胎移植周期中获卵数≤4个周期共103个,按受精方式分为常规IVF组(46周期)与ICSI组(57周期),分析比较两组间受精率、正常受精率、卵裂率、受精失败发生率及临床妊娠率的差异。结果:IVF组受精率、正常受精率和卵裂率分别为78.7 %、72.6%和95.1 %,ICSI组受精率、正常受精率和卵裂率分别为72.0 %、66.4 %和96.8 %,两组间差异无统计学意义(P>0.05); IVF组受精失败发生率为15.56%,高于ICSI组的1.75%(P<0.05);IVF组获卵周期妊娠率为27.27%,移植周期妊娠率为33.33%,均高于ICSI组的9.09%与11.11%(P<0.05)。 结论:对于无明确男性因素的卵巢低反应IVF周期,行ICSI并不能提高其受精率和临床妊娠率。 【关键词】IVF-ET;卵巢反应不良;受精方式  相似文献   

6.
常规IVF不受精周期行补救卵母细胞单精子注射   总被引:11,自引:0,他引:11  
 【目的】探讨常规体外受精胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)不受精时,应用卵母细胞单精子显微注射(intracytoplasmic sperm injection,ICSI)技术进行补救授精的临床意义。【方法】2001年8月~2005年8月,在499个常规IVF-ET周期中有25个周期完全不受精,进行补救ICSI,并与同期实施的179个正常ICSI周期进行比较。【结果】补救ICSI组与正常ICSI组比较,HCG日平均血清雌二醇水平、每个成熟卵泡平均血清雌二醇量、每个周期的获卵数无明显差别,补救ICSI受精率为57.7%,低于正常ICSI组(67.8%),补救ICSI组平均每个周期获得胚胎数(7.8±3.9)比正常ICSI(10.0±4.9)组少,且有统计学意义(P〈0.01)。补救ICSI组≥4细胞的胚胎占总胚胎数的54.5%,低于正常ICSI组(87.5%),有统计学意义(P〈0.01)。正常ICSI组妊娠率为38.5%,补救ICSI组无一例妊娠。补救ICSI组中有8例在下一周期行ICSI,有2例妊娠并分娩2个健康女婴。【结论】补救ICSI虽可以避免取消IVF周期,但其受精率和妊娠率低,其临床应用价值还有待于进一步探讨。对于常规IVF不受精的患者,再次治疗时可考虑行ICSI助孕。  相似文献   

7.
两种补救性ICSI在常规体外受精中的应用   总被引:1,自引:0,他引:1  
目的探讨在常规体外受精-胚胎移植(IVF-ET)周期中不受精及受精率低的情况下,应用卵胞浆内单精子显微注射(ICSI)进行补救后获得胚胎移植的临床应用价值。方法选择IVF周期中发生完全不受精及受精率<30%的病例97个周期,其中57个周期行晚期补救ICSI,40个周期行早期补救ICSI,两种补救ICSI在完全不受精组和受精率低组中分别进行比较。结果在不受精组中,早期补救的2PN受精率、种植率和妊娠率分别为69.44%、28.00%、30.77%,明显高于晚期补救ICSI的56.23%、1.00%、2.50%(P<0.05或P<0.01),在低受精率组中两者的累计妊娠率、种植率差异无显著性(P>0.05),但受精率、优质胚胎率、胚胎冷冻率差异有高度显著性(P均<0.01)。结论早期补救ICSI较晚期ICSI的2PN受精率、胚胎种植率高,能更好地改善补救ICSI的妊娠结局。  相似文献   

8.
【目的】探讨常规体外受精胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)不受精时,应用卵母细胞单精子显微注射(intracytoplasmic sperm injection,ICSI)技术进行补救授精的临床意义。【方法】2001年8月~2005年8月,在499个常规IVF-ET周期中有25个周期完全不受精,进行补救ICSI,并与同期实施的179个正常ICSI周期进行比较。【结果】补救ICSI组与正常ICSI组比较,HCG日平均血清雌二醇水平、每个成熟卵泡平均血清雌二醇量、每个周期的获卵数无明显差别,补救ICSI受精率为57.7%,低于正常ICSI组(67.8%),补救ICSI组平均每个周期获得胚胎数(7.8±3.9)比正常ICSI(10.0±4.9)组少,且有统计学意义(P〈0.01)。补救ICSI组≥4细胞的胚胎占总胚胎数的54.5%,低于正常ICSI组(87.5%),有统计学意义(P〈0.01)。正常ICSI组妊娠率为38.5%,补救ICSI组无一例妊娠。补救ICSI组中有8例在下一周期行ICSI,有2例妊娠并分娩2个健康女婴。【结论】补救ICSI虽可以避免取消IVF周期,但其受精率和妊娠率低,其临床应用价值还有待于进一步探讨。对于常规IVF不受精的患者,再次治疗时可考虑行ICSI助孕。  相似文献   

9.
目的:探讨采用精子卵胞浆内注射(ICSI)对于常规体外受精和胚胎移植(IVF-ET)受精失败的次级卵母细胞实施补救受精的效果。方法:对在常规IVF-ET中没有得到受精卵的病例的次级卵母细胞实施ICSI,观察受精、卵裂、胚胎种植和受孕情况。结果:2000年1月~2000年12月在我院生殖中心接受常规IVF治疗的夫妇中,12例在授精后12~20 h卵子全部不受精,在取卵后24 h实施ICSI。12例患者有卵111个,对其中的69个次级卵母细胞实施ICSI, ICSI 20 h后检查,56个受精,受精率81.2%,形成胚胎50个,卵裂率89.3%,移植11个周期共38胚胎,临床妊娠1例(双胎)。胚胎着床率为5.3%。结论:在常规IVF无受精的情况下,应当立即实施ICSI以补救。但在此情况下,胚胎的着床率低下。  相似文献   

10.
同源卵母细胞在输卵管性不孕患者行IVF和ICSI的结果比较   总被引:3,自引:0,他引:3  
目的 比较分析同源卵母细胞分别实施常规体外受精(IVF)和卵胞浆内单精子显微注射(ICSI)的结果.方法 回顾性分析2006年8月至2008年8月因输卵管因素不孕的夫妇的48个治疗周期,将同胞卵和同一份精液行常规IVF和ICSI后的结果进行比较分析.结果 48例患者中常规IVF完全受精失败8例,ICSI均受精,完全受精失败率为16.7%;IVF、ICSI均受精组中ICSI受精率(78.6%)高于常规IVF(66.4%),差异有统计学意义(P<0.01).移植常规IVF受精胚胎17例,临床妊娠7例,临床妊娠率41.2%;移植ICSI受精胚胎15例,临床妊娠6例,临床妊娠率40.0%;混合移植IVF+ICSI受精胚胎16例,临床妊娠6例,临床妊娠率37.5%,差异无统计学意义(P>0.05).结论 对于输卵管性不孕且可疑或高危IVF受精障碍人群在首次IVF助孕治疗时,可选择将部分卵行ICSI,减少取消移植的风险.  相似文献   

11.
Objective To evaluate the application value of rescue ICSI in fertilization failure after conventional IVF and choose the best rescue window before oocyte aging according to the results of rescue ICSI performed in different time. Methods The data of 93 IVF cycles were analyzed retrospectively. Rescue ICSI was performed in these cycles after conventional IVF failure. Because of the different rescue time, these cycles were divided into two groups: early rescue group (group A, 77 cycles, rescue ICSI performed 4-8 h after conventional IVF) and late rescue group (group B, 16 cycles, rescue ICSI performed 20-22 h after conventional IVF). Results There were no statistically significant differences in age of female, duration of infertility, number of oocytes retrieved every cycle. The normal fertilization rate, pregnancy rate and implantation rate were decreased in group B compared with those in group A (P<0.05). In group A, the normal fertilization rate of rescue ICSI performed 4-6 h after conventional IVF (group A1) was increased compared with that of rescue ICSI performed 6-8 h (including 6 h) after conventional IVF (group A2)(66.5% vs 55.9%)(P<0.05); while the abnormal fertilization rate in group A1 was decreased compared with group A2 (9.0% vs 14.4%)(P<0.05). Clinical pregnancy rate was slight higher in group A1 than in group A2, though this failed to be significantly different. Conclusion Rescue ICSI is effective if fertilization was failure after conventional IVF, the most important thing is to choose the reasonable rescue window before oocyte aging when ICSI is performed.  相似文献   

12.
目的:分析常规体外受精(IVF)完全受精失败和低受精随后周期行单精子卵胞浆内注射(ICSI)的临床结果。方法:2001年10月至2007年5月,30例IVF完全不受精和12例IVF低受精不育夫妇分别在随后周期采取38个周期(A组)和17个周期(B组)ICSI治疗,同期因男性因素行第1周期ICSI治疗的281个周期作为对照(C组),比较三组的正常受精率、优质胚胎率、胚胎种植率和临床妊娠率。结果:三组间正常受精率、优质胚胎率和临床妊娠率差异均无显著性;A组的胚胎种植率为14.3%,明显低于B组和C组(29.5%和26.0%,P均〈0.05)。结论:IVF低受精患者在随后周期改行ICSI可获得理想的临床治疗效果,IVF完全受精失败患者随后周期改行ICSI的胚胎种植率较低,表明其完全受精失败至少部分原因是由于卵子异常而导致胚胎发育潜能的下降。  相似文献   

13.
Objective To determine whether rescue intracytoplasmic sperm injection (ICSI) is associated with improved outcomes for non-male factor infertility. Methods The changes of micro-structure, including meiotic spindle and chromosome distribution, sperm penetration, as well as oocyte activation were compared in IVF (in vitro fertilization) fertilization failure (IVF FF) patients, ICSI patients with non-fertilized oocytes (ICSI NF) and oocytes in vitro maturation (IVM). Results A total of 164 unfertilized oocytes (93 oocytes in IVF and 71 oocytes in ICSI) and 56 IVM oocytes were available for this study. The abnormality of spindle and chromosomes was significantly higher in IVF FF group than that in ICSI NF group or IVM group (abnormal spindle rates were 80.6%, 64.8% and 57.1%, respectively; abnormal chromosome rates were 91.4%, 80.3% and 75.0%, respectively). No sperm penetration after IVF and sperm expulsion after ICSI were 78.5% and 40.8%, respectively. Activation failure occurred in 16.1% of the IVF FF cases and 49.3% of ICSI NF oocytes. Conclusion Rescue ICSI of fertilization-failed oocytes fails to lead outcome improvement due to the internal defects of oocytes.  相似文献   

14.
目的探讨卵胞浆内单精子注射(ICSI)操作过程对胚胎发育的影响。方法 选取53个体外受精-胚胎移植治疗不 育症周期为对象,将同一周期的同胞卵子分为两组,分别进行ICSI和常规体外受精(IVF),比较两组的胚胎发育情况。结 果ICSI组受精率78%,显著高于常规IVF组67%的受精率,但卵子的溶散率亦高(8%νs3.4%);ICSI组的优良胚胎数 与IVF组相比,差异不显著(P>0.05),但碎片率大于50%的胚胎数前者与,后者差异具有显著性(P<0.01);移植后ICSI组 可供冻融的胚胎数较常规IVF组少。结论ICSI操作对卵子及其后的胚胎发育潜能有影响。  相似文献   

15.
目的 探讨分半ⅣF/ICSI(half-ICSI)在有受精失败风险患者中的临床应用价值.方法 2009年8月~2010年8月于我科行half-ICSI共36周期,同一周期取得的卵子随机分半,分别进行常规体外受精(IVF)与卵胞浆内单精子显微注射(ICSI),比较不同受精方式的受精率、卵裂率及优质胚胎率,并与同期接受常规IVF的连续312个周期作为对照.结果 Half-ICSI周期中ICSI受精率(81.38%)明显高于IVF受精率(41.28%),IVF完全受精失败率(19.44%)及受精低下率(27.78%)明显高于ICSI完全受精失败率(0)及受精低下率(5.56%),差异有统计学意义(P<0.05);IVF和ICSI的卵裂率及优质胚胎率比较,差异无显著性(P>0.05);Half-ICSI周期的胚胎种植率及临床妊娠率同常规IVF周期比较,差异无显著性(P>0.05).结论 存在受精失败风险患者应用half-ICSI,可以在一定程度上增加其受精率,减少取消移植的风险,增加妊娠机会.  相似文献   

16.
Todate ,therearenounivresallyacceptedselec tioncriteriaforassistedreproductivetechnology(ART ) .Forexample ,thechoiceoftreatmentforcoupleswithsubfertilemaleorunexplainedinfertilityisoftenempiricalandmayleadtocompletefertiliza tionfailureafterconventionali…  相似文献   

17.
This study aimed to investigate whether intracytoplasmic sperm injection (ICSI) shows an advantage over in vitro fertilization (IVF) in non-male factor cycles as the number of oocytes retrieved decreases from four to one. We undertook a retrospective analysis of 1305 IVF/ICSI cycles of non-male factor in which four or fewer oocytes were retrieved. Comparisons were made between conventional IVF (CI) and ICSI when one, two, three or four oocyte(s) were retrieved. Primary outcomes including normal fertilization rate, proportion of embryos per obtained oocyte, cycle cancellation rate, implantation rate, clinical pregnancy rate (PR), live birth rate (LBR), cumulative PR and cumulative LBR were evaluated. The results showed that the normal fertilization rate (72.5% vs. 50.0%) and the proportion of embryos per obtained oocyte (72.5% vs. 55.0%) were significantly increased in one oocyte retrieved cycles in ICSI group as compared with CI group. However, the proportion of embryos per obtained oocyte was markedly decreased in ICSI group when three (52.3% vs. 61.3%) or four (56.9% vs. 64.0%) oocytes were retrieved. The implantation rates, clinical PRs, LBRs, cumulative PRs and cumulative LBRs in CI group were comparable to those in ICSI group when one, two, three or four oocyte(s) were retrieved. In conclusion, ICSI doesn't show advantages over IVF in low oocyte yield cycles of non-male factors, even when only one oocyte was retrieved.  相似文献   

18.
Background For patients with severe endometriosis, the spontaneous pregnancy rates have been reported to be near 0 due to extreme distortion of normal pelvic anatomy.Surgery is one of the treatment options; however, if patients failed to conceive after surgery, in vitro fertilization (IVF) is effective.The objective of this retrospective study was to determine the clinical characteristics of IVF/intracytoplasmic sperm injection (ICSI) in patients with stage Ⅲ/Ⅳ endometriosis, and to determine the impact of the interval from surgery to IVF/ICSI on outcome.Methods One hundred and sixty patients who were diagnosed with stage Ⅲ/Ⅳ endometriosis underwent IVF/ICSI cycles between February 2004 and June 2009 were enrolled.The mean interval from surgery to IVF, number of oocytes retrieved, fertilization rate, implantation rate, embryos transferred, and good embryos transferred were compared between two age groups (≤35 years and 〉 35 years).Results The mean interval from surgery to IVF was (37.9±28.9) months for the group ≤ 35 years of age and (57.6±39.7)months for the group 〉35 years of age.Twenty-five IVF/ICSI cycles (12.8%) were performed during the first year after surgery, and 34.9% IVF/ICSI cycles were performed 2 years after surgery.No significant differences existed between the two groups with respect to the fertilization rate, implantation rate, number of embryos transferred, number of good embryos,clinical pregnancy rates, live birth rates, and cumulative clinical pregnancy rates (P 〉0.05).The probability of cumulative clinical pregnancies was 75%, 50%, and 25% ((29.0±4.8), (61.0±7.6), and (120.0±16.9) months after surgery, respectively).Conclusions For infertile patients with stage Ⅲ/Ⅳ endometriosis, the optimal time to conceive by IVF/ICSI is 〈2 years after surgery; nevertheless, most of the patients took a longer time to conceive.  相似文献   

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