短时受精失败后行早补救ICSI的临床应用研究

目的:探讨短时受精失败后行早补救ICSI的应用价值。方法:对2010年10月～2011年6月在唐山市妇幼保健院生殖遗传科接受IVF-ET治疗的28例患者(观察组)进行短时受精观察,于受精后4～6 h去除卵丘细胞,观察卵子的第二极体的排出情况,对第二极体排出率低于1/2的周期实施早期补救ICSI(观察组)。选择同期行ICSI治疗的63例患者作为对照组,比较两组的受精及妊娠情况。结果:观察组受精率高于对照组,差异有统计学意义(P<0.05),但多精受精率、优胚率、妊娠率无统计学意义(P>0.05)。结论:短时受精后行早补救ICSI能极大地提高卵母细胞的利用率,并获得很好的临床妊娠结局,对预防及降低受精失败有重要意义。

Clinical application and research on early rescue ICSI after short-period fertilization failure

Objective:To explore the application value of early rescue intracytoplasmic sperm injection(ICSI) after short-period fertilization failure. Methods:Twenty-eight patients(observation group) who received in vitro fertilization and embryo transfer(IVF-ET) in genetic department of the hospital from October 2010 to June 2011 were treated with short-period fertilization,then cumulus cells were removed after 4-6 hours,discharge of second polar body of oocytes was observed,early rescue ICSI was performed during the cycles with discharge rate of second polar body less than one half(observation group).Sixty-three patients who received ICSI during the same period were selected as control group,the fertilization rates and pregnancy rates in the two groups were compared. Results:The fertilization rate in observation group was statistically significantly higher than that in control group(P<0.05),but there was no statistically significant difference in polyspermy rate,high quality embryo rate,and pregnancy rate between the two groups(P>0.05). Conclusion:Early rescue ICSI after short-period fertilization failure can improve the utilization rate of oocytes significantly and obtain good clinical pregnancy outcome,which has important significance for preventing and reducing fertilization failure.