非男性因素不孕超促排卵低获卵周期IVF和ICSI效果比较

目的探讨非男性因素不孕超促排卵低获卵周期体外受精.胚胎移植(IVF)和卵子胞浆内单精子注射(ICSI)两种授精方式对受精效果、胚胎发育潜能及助孕结局的影响,为明确ICSI指征提供临床依据。方法回顾分析南方医院生殖医学中心的220个非男性因素不孕患者超促排卵低获卵周期,将其分为IVF组(151例)和ICSI组(69例),对两组患者的一般情况、促排卵过程中卵巢反应性指标、受精、胚胎质量和妊娠情况进行分析。结果两组受精率、正常受精率、完全受精失败率、卵裂率、优质胚胎率、胚胎着床率、临床妊娠率及完全受精失败率无显著性差异,但IVF组受精率、正常受精率、卵裂率、优质胚胎率及临床妊娠率呈增高趋势;完全受精失败率呈降低趋势。结论 ICSI即无法改善非男性因素不孕超促排卵低获卵患者的受精情况,对提高其胚胎发育潜能及改善最终妊娠结局也无益处,不建议对该部分患者常规行ICSI治疗。

Outcomes of in vitro fertilization-embryo transfer and intracytoplasmic sperm injection for non-male infertility patients with a low number of oocytes retrieved

Objective To compare the outcomes of in vitro fertilization-embryo transfer(IVF) and intracytoplasmic sperm injection(ICSI) in non-male infertility patients with a low number of oocytes retrieved and provide evidences for defining the indications of ICSI.Methods A retrospective analysis was conducted among 220 non-male infertility patients with a low number of oocyte retrieved(≤5) including 151 receiving IVF and 69 undergoing ICSI.The baseline characteristics,ovary response index,fertilization results,embryo quality and clinical outcomes were compared between the 2 groups.Results Although the fertilization rates,normal fertilization rates,complete fertilization failure rates,cleavage rates,good embryo rates,implantation rates and clinical pregnancy rates showed no significant differences between the 2 groups,the complete fertilization failure rates tended to decrease and the other indices tended to increase in IVF group.Conclusion ICSI can not improve the fertilization results,embryonic development potential or clinical outcomes in non-male infertility patients with a low number of oocytes retrieved,and is therefore not recommended for these patients.