辅助生殖中受精的方式与自然流产关系的探讨

目的 探讨在辅助生殖中不同的受精方式与自然流产的关系.方法 行体外受精-胚胎移植(IVF-ET)及单精子卵细胞浆内显微注射-胚胎移植(ICSI-ET)助孕的481个周期进行回顾性分析,按不同的受精方式分为IVF-ET组和ICSI-ET组,比较两组的一般临床资料、早期流产和晚期流产发生率.结果 ICSI-ET组的不孕年限、用促性腺激素(Gn)总量(支数)均低于IVF-ET组(P均＜0.05),两组的的年龄、Gn启动剂量、用Gn天数、移植胚胎数、ET优质胚胎数目差异均无统计学意义(P均>0.05),ET后妊娠总的自然流产率17.54%,其中受精方式为IVF妊娠者早期流产率和晚期流产率分别为12.93%和4.08%,受精方式为单精子卵细胞浆内显微注射(ICSI)者早期流产率和晚期流产率为20.83%和0.00%,两组早期流产率和晚期流产率差异无统计学意义(P>0.05).结论 行ART助孕妊娠者早期流产率与自然受孕妊娠者的早期流产率10%～15%相近,行ICSI妊娠者早期自然流产率和晚期流产率与行IVF妊娠者相比无差别.

Study of relationship between means of fertilization and spontaneous abortion among pregnancies conceived using assisted reproductive technology

Objective To investigate relationship between the means of fertilization and spontaneous abortion among pregnancies conceived using assisted reproductive technology.Methods Four hundred and eighty one cycles of patients were retrospectively analyzed,and devided into two groups according to the means of fertilization.The general data,early spontaneous abortion rate and late spontaneous abortion rate were analysed.Results Duration of infertility and total Gn dosage of intracytoplasmic sperm injection(ICSI)group were significantly lower than that of in vitro fertilization(IVF)group.Infertility duration,dosage of start,days of Gn,the number of embryo transfer(ET)and the high quality embryo of ET were not significantly different between the two groups.The total spontaneous abortion rate of pregnancies conceived using assisted reproductive technology was 17.54%.The early spontaneous abortion rate of IVF group was 12.93% while that of ICSI group was 20.83%.The late spontaneous abortion rate of IVF group was 4.08% while that of ICSI group was 0.00%.There were not significantly difference beween the two groups.Conclusion The early spontaneous abortion rate among pregnancies using assisted reproductive technology was correspondent with that among natural pregnances.The early spontaneous abortion rate and the late spontaneous abortion rate were not significantly different among pregnancies through IVF and ICSI.