对常规IVF未受精周期不同时间实施补救ICSI的比较

目的:比较常规体外受精(IVF)中未受精的病例在不同时间行补救卵胞浆内单精子注射(ICSI)再受精的临床结局,以探讨补救ICSI的临床应用价值及最佳的补救时机。方法:回顾性分析2007年1月～2009年7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治疗未受精并实施补救ICSI的93例患者,根据补救ICSI实施时间的不同,分为晚补救组(常规体外受精后20～22 h实施补救ICSI1,6例)和早补救组(常规体外受精后4～8 h实施补救ICSI7,7例)。结果:晚补救组与早补救组在女性年龄、不孕年限、平均每周期获卵数方面进行比较均无统计学差异(P>0.05)。但晚补救组的正常受精率、卵裂率和妊娠率都低于早补救组(52.0%vs63.0%,87.5%vs94.1%,0%vs43.5%),两组之间比较差异具有统计学意义(P<0.05)。结论:常规IVF受精失败后行补救ICSI再受精是切实可行的,而合理的补救时间是获得理想临床结局的关键。

Comparison of rescue ICSI at different times of non-IVF cycles in conventional IVF

Objective:To compare the clinical outcomes of rescue intracytoplasmic sperm injection(ICSI) at different times of non-IVF cycles in conventional IVF,explore its clinical application value and the optimal rescue time. Methods:93 cases receiving conventional IVF and rescue ICSI in the hospital from January 2007 to July 2009 were analyzed retrospectively;according to the different rescue ICSI times,they were divided into late rescue ICSI group(rescue ICSI was performed at 20～22 hours after conventional IVF,16 cases) and early rescue ICSI group(rescue ICSI was performed at 4～8 hours after conventional IVF,77 cases). Results:There was no significant difference in maternal age,duration of infertility and the mean number of oocytes retrieved every cycle between the two groups(P>0.05).The normal fertilization rate,cleavage rate and pregnancy rate in late rescue ICSI group were significantly lower than those in early rescue ICSI group(52.0% vs 63.0%,87.5% vs 94.1%,0% vs 43.5%,respectively)(P<0.05). Conclusion:Rescue ICSI is effective if fertilization is failure after routine IVF,and reasonable rescue time is the key of achieving ideal clinical outcome.