短时受精后补救ICSI的临床应用研究

目的:探讨降低体外受精-胚胎移植(IVF-ET)中受精失败的有效方法。方法:对行IVF治疗的600个周期进行短时受精观察,于受精后5h左右去除卵丘细胞,观察卵子第二极体的排出情况;对第二极体排出率低于1/2的周期追加观察至受精后9h,如果存在可疑受精低下及全卵受精失败,则予以早补救卵细胞浆内单精子注射(ICSI)治疗(观察组);选择同时期连续进行ICSI治疗的患者共49个周期(对照组);比较两组的受精及妊娠情况。结果:两组的正常受精率、多精受精率、正常卵裂率及优质胚胎率差异有统计学意义(P<0.01);临床妊娠率差异无统计学意义(P>0.05)。结论:IVF-ET中短时受精后早补救ICSI不影响临床妊娠率,对预防及降低受精失败有重要意义。

The clinical application research of rescue ICSI after Short-period fertilization

Objective：To explore the effective method of reducing fertilization failure in in vitro fertilization and embryo transfer （IVF-ET）. Methods： In 600 IVF treatment cycles,the polar bodies were observed after short-period sperm-oocyte coincubation and the cumulus cells were removed 5 hours after fertilization. The cycle in which the rate of polar body extrusion was less than 50 percent was observed for additional 9 hours. The women who experienced lower fertilization and the total fertilization failure were treated with intracytoplasmic sperm injection （rescue ICSI） to acquire fertilization （the study group）. The women underwent 49 ICSI treatment cycles were as the control. Results： The normal fertility rate,polyspermous fertilization rate,normal cleavage rate and high quality embryos rate had significant differences between the two groups （P〈0.01）,but the clinical pregnancy rate had no significant difference between the two groups （P〉0.05）. Conclusion： Early rescue ICSI do not influence clinical pregnancy rate in IVF-ET after short-period sperm-oocyte coincubation,and it is important to prevent and reduce fertilization failure.