不同来源精子行体外受精/卵胞浆内单精子显微注射所得胚胎冻融及移植后妊娠结局比较

目的分析体外受精（IVF）与不同来源精子卵胞浆内单精子显微注射（ICSI）所得胚胎在冻融及移植后的情况。方法选择2007年3月至2009年8月我院生殖中心进行复制的107例患者共131个冻融胚胎移植（FET）周期,据FET胚胎来源分为IVF组、ICSI组;ICSI组又分射出精子组（A组）、附睾精子组（B组）、睾丸精子组（C组）。结果IVF组与ICSI组胚胎存活率、移植胚胎占解冻胚胎比例、平均移植胚胎数、临床妊娠率、胚胎种植率、流产率比较,差异均无显著性意义（P〉0.05）;A、B、C组胚胎存活率、移植胚胎占解冻胚胎比例、平均移植胚胎数、胚胎种植率比较,差异均无显著性意义（P〉0.05）;B、C组临床妊娠率比较,差异无显著性意义（P〉0.05）,但均明显高于A组（P〈0.05）;A组患者62.5%存在女方不孕因素,比例明显高于B、C组（P〈0.05）。结论IVF和不同来源精子行ICSI所得的优质胚胎经受冷冻解冻的能力没有差异;ICSI所得胚胎行FET时,女方同时存在不孕因素是影响妊娠率的因素之一。

A comparison of post-thaw results between embryos arising from in-vitro fertilization or intracytoplasmic sperm injection using surgically retrieved or ejaculated spermatozoa

Objective To study the effect of freeze–thaw on embryos derived from in-vitro fertilization or intracytoplasmic sperm injection（ICSI）using surgically retrieved and ejaculated spermatozoa. Methods Analysis was made on 131 FET cycles. According to the embryos＇ origin,the 131 FET cycles were divided into IVF group and ICSI group; the latter was divided into ejaculated sperm group（A group）,epididymal spermatozoa group（B group）,testicular spermatozoa group（C group）. Results No difference was found between the IVF and ICSI groups in terms of post-thaw survival rate,the proportion of transfer embryos to thawed embryos,average number of transfer embryo,pregnancy rate,implantation rate and miscarriage rate. No difference was found among A,B and C groups in terms of post-thaw survival rate,the proportion of transfer embryos to thawed embryos,average number of transfer embryo and implantation rate. The pregnancy rate of A group was lower than that of B and C groups. The proportion of female sterility factors of A group was higher significantly than that of B and C groups. Conclusions Cleavage embryos arising from IVF cycles and ICSI cycles using ejaculated spermatozoa,testicular and epididymal spermatozoa can equally endure frozen and thaw process. The existence of female sterility factor was one of the factors which would affect the pregnancy rate of FET with embryos derived from intracytoplasmic sperm injection （ICSI） using surgically retrieved and ejaculated spermatozoa.