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1.
Outcome of conventional IVF and ICSI on sibling oocytes in mild male factor infertility 总被引:10,自引:0,他引:10
Plachot M Belaisch-Allart J Mayenga JM Chouraqui A Tesquier L Serkine AM 《Human reproduction (Oxford, England)》2002,17(2):362-369
BACKGROUND: Decisions concerning the treatment choice for assisted reproduction (IVF or ICSI) are usually made after the evaluation of male fertility factors, or after taking into account the results of previous IVF attempts. There are no widely accepted criteria, so decisions for couples with male subfertility are often empirical and may lead to complete fertilization failure after IVF, or to the unnecessary use of ICSI. METHODS: A study was conducted in which half the oocytes from each of 58 couples with moderate oligo +/- astheno +/- teratozoospermia were inseminated (conventional IVF) and the other half microinjected (ICSI). The technique used for subsequent cycles depended on the results of the first cycle. RESULTS: Nineteen of the 58 IVF/ICSI attempts resulted in fertilization after ICSI only (32.8%) and 39 in fertilization after IVF and ICSI (67.2%). For patients with oocyte fertilization only after ICSI, 61.5% of the oocytes microinjected were fertilized. A mean of 2.2 embryos per patient were transferred, leading to eight clinical pregnancies (42.1%).The implantation rate was 21.4%. All subsequent cycles were carried out with ICSI. Couples with oocyte fertilization after both IVF and ICSI had slightly better semen characteristics than those with oocyte fertilization only after ICSI, but this difference was not significant. Overall, no statistically significant difference was observed between IVF and ICSI in sibling oocytes for any of the variables studied: fertilization rate, embryo morphology and rates of development, pregnancy and implantation. Although only small numbers of oocytes or embryos were available for each couple, six couples had lower fertilization rates after IVF and eight had lower embryo quality after IVF. Eight patients had lower sperm quality in the second cycle, and only seven couples underwent subsequent IVF cycles. CONCLUSIONS: This strategy enabled us to avoid 32.8% of complete fertilization failures after IVF, but not to decrease significantly the number of ICSI attempts in subsequent cycles. However, the uncertainties concerning the safety of ICSI suggest that ICSI should be used cautiously and judiciously. 相似文献
2.
Farhi J.; Ashkenazi J.; Feldberg D.; Dicker D.; Orvieto R.; Ben Rafael Z. 《Human reproduction (Oxford, England)》1995,10(10):2576-2578
The effect of uterine leiomyoma on infertility is subject tocontroversy. Two main mechanisms associating leiomyomata andinfertility have been suggested: the obstruction of gamete transportand impaired implantation. In-vitro fertilization (IVF) is aunique setting for examining the effect of leiomyomata on theimplantation rate. This study was designed to determine theimpact of uterine leiomyomata on the results of IVF. In a retrospectiveanalysis of IVF cycles, 46 women with documented uterine leiomyomawere compared with a control group with mechanical infertility.The implantation rate and pregnancy outcome in relation to theleiomyoma were observed. Implantation (22.1%/transfer, 6.8%/embryo)and abortion rates (36%)in the study group were similar to theresults in the control group with pure mechanical factor. Ananalysis of IVF results according to the hysteroscopic pretreatmentfindings revealed that impaired implantation is associated withleiomyoma only where uterine intracavitary abnormalities co-exist.We conclude that implantation rate and pregnancy outcome areimpaired in women with uterine leiomyomata only when they causedeformation of the uterine cavity. In patients with leiomyomataassociated with an abnormal uterine cavity, surgical treatmentshould be considered prior to IVF because of the reduced implantationrate. 相似文献
3.
Ubaldi F Rienzi L Ferrero S Anniballo R Iacobelli M Cobellis L Greco E 《Human reproduction (Oxford, England)》2002,17(6):1544-1547
BACKGROUND: Glucocorticoids have been used in conjunction with zona dissection to improve pregnancy and implantation rates in IVF patients. The aim of this prospective randomized study was to evaluate the effect of low-dose prednisolone in addition to the standard protocol, on pregnancy and implantation rates in routine ICSI patients before and after embryo replacement. METHODS: A total of 313 patients in 360 consecutive cycles (patients <39 years old and with three or less than three ICSI attempts) performed at our centre were randomly assigned by computer-generated list to receive either prednisolone (10 mg/day in two divided doses), starting on the first day of ovarian stimulation and continuing for 4 weeks (group A), or no treatment (group B). RESULTS: The mean age, number of previously failed IVF attempts, basal FSH levels and the mean rank of trials were comparable between groups A and B. The mean (+/- SD) number of metaphase II oocytes retrieved (11.9 +/- 5.5 versus 12.0 +/- 5.1), 2-pronuclei fertilization rate (67.2 versus 65.8%), the pregnancy and the implantation rates were not different between the study and control groups (49.0 and 23.6% versus 50.0 and 23.3% respectively). CONCLUSION: Low-dose prednisolone treatment in addition to the standard protocol before and after embryo replacement does not appear to have a significant effect on pregnancy or implantation rates. 相似文献
4.
Hu Y; Maxson W; Hoffman D; Ory S; Eager S; Dupre J; Worrilow K 《Human reproduction (Oxford, England)》1998,13(1):165-168
Commercially obtained Buffalo rat liver (BRL) cells were grown in monolayer
culture. The effect of BRL cell co-culture with assisted hatching on embryo
development, implantation and pregnancy was investigated in a population of
200 'first-time' in-vitro fertilization (IVF) patients, subdivided into
three groups according to the methods of fertilization [IVF;
intracytoplasmic sperm injection (ICSI); ICSI/IVF]. Assisted hatching was
performed on all embryos chosen for transfer. Following co-culture, the
overall embryo quality, implantation rate and pregnancy rates were not
significantly different from the controls. However, when grouped according
to fertilization method, co-culture was found to have an impact on
pregnancy and implantation rates in the group undergoing conventional IVF.
Using co- culture with assisted hatching, we were able to achieve a 58%
(38/65) clinical pregnancy rate with a 49% (32/65) live birth rate and a
26% (60/235) implantation rate. No changes in the pregnancy and
implantation rates were apparent in ICSI or ICSI/IVF subgroups. This is the
first prospective, randomly controlled study which reports the use of BRL
cell co-culture for human IVF for a large number of patients undergoing IVF
for the first time.
相似文献
5.
IVF versus ICSI in sibling oocytes from patients with polycystic ovarian syndrome: a randomized controlled trial 总被引:6,自引:0,他引:6
Hwang JL Seow KM Lin YH Hsieh BC Huang LW Chen HJ Huang SC Chen CY Chen PH Tzeng CR 《Human reproduction (Oxford, England)》2005,20(5):1261-1265
BACKGROUND: This study compares the fertilization rate and embryonic development of oocytes randomly inseminated by conventional IVF or ICSI in patients with polycystic ovarian syndrome (PCOS) and normozoospermic semen during IVF cycles. METHODS: Sibling oocytes were randomized to be inseminated either by ICSI or IVF. Fertilization rate (two pronuclei/COC), day 2 embryonic morphology and rate of development were assessed. RESULTS: A total of 1089 cumulus-oocyte complexes (COC) were collected in 60 cycles (mean+/-SD, 18.2 +/- 7.2). Totals of 541 and 548 COC were inseminated by IVF and ICSI respectively, with a significantly higher fertilization rate in the ICSI group (ICSI versus IVF, 72.3 +/- 15.5 versus 44.8 +/- 25.1%). No fertilization failure occurred in the group of oocytes inseminated by ICSI, whereas the COC in nine patients (15%) inseminated by IVF had complete fertilization failure. The day 2 embryonic morphology and rate of development were not different regardless of the insemination method. CONCLUSIONS: Our results suggested that another randomized controlled study, randomizing patients instead of sibling oocytes, should be undertaken to compare the pregnancy rate per started cycle and to see whether ICSI should be performed on all, or at least on a portion of, oocytes for patients with PCOS undergoing IVF cycles. 相似文献
6.
Controlled comparison of conventional in-vitro fertilization and intracytoplasmic sperm injection in patients with asthenozoospermia. 总被引:3,自引:0,他引:3
G Verheyen H Tournaye C Staessen A De Vos M Vandervorst A Van Steirteghem 《Human reproduction (Oxford, England)》1999,14(9):2313-2319
A controlled comparison between conventional in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) has been carried out for patients with =5% rapid progressive (type A) spermatozoa in their fresh semen. Twenty couples were allocated to the study. All semen samples fulfilled the minimum criteria to be allocated to the conventional IVF programme. The two pronuclear (2PN) fertilization rate per retrieved cumulus-oocyte complex was significantly higher after ICSI (63.4%) than after conventional IVF (22.9%), with complete fertilization failure after IVF in 10 out of the 20 cycles. Embryo quality was similar for both treatments. Sixteen patients received only ICSI embryos, two patients only IVF embryos and two patients received IVF and ICSI embryos. The ongoing clinical pregnancy rate was 45%, the implantation rate was 37%. Comparison of the characteristics of patients/cycles with and without 2PN fertilization revealed a higher proportion of progressively motile spermatozoa in the prepared sperm fraction for the group of patients with fertilization after conventional IVF. It can be concluded from this study that absence of or an extremely low proportion of rapid progressive motility in fresh semen indicates a high risk of complete fertilization failure with conventional IVF. 相似文献
7.
Khalaf Y Ross C El-Toukhy T Hart R Seed P Braude P 《Human reproduction (Oxford, England)》2006,21(10):2640-2644
BACKGROUND: This study aimed to evaluate the effect of small intramural fibroids on the cumulative pregnancy, ongoing pregnancy, live birth and implantation rates after three IVF/ICSI attempts. METHODS: The first three treatment cycles of women enrolled for IVF/ICSI over a 12-month period were analysed. Only patients with small (相似文献
8.
Comparison between day-2 embryos obtained either from ICSI or resulting from short insemination IVF: influence of maternal age 总被引:5,自引:0,他引:5
Short incubation time prevents deleterious effects of cumulus cell degeneration and excess spermatozoa in IVF embryos. We performed a short incubation (3 h) protocol in 328 IVF cycles, in order to compare the developmental potential of regular IVF embryos with those originating from 316 cycles entered our intracytoplasmic sperm injection (ICSI) programme over the same period. Embryo transfers were performed in all patients on day 2. The mean number of embryos transferred was 1.92 for the ICSI group and 1.73 for the IVF group (P < 0.007). This was related only to the wishes of patients. However, the policy of the centre is to transfer a low number of embryos in young patients in order to avoid multiple pregnancies. All spare embryos were permitted to grow to the blastocyst stage for freezing. Shortening incubation time did not decrease fertilization rates. In our overall population, no difference was observed in the implantation rates per embryo for IVF (19%) or for ICSI (20%). An age-related decrease in embryo production was observed for both groups of patients (P < 0.01 for ICSI and P < 0.001 for IVF). The age-related decrease in embryo implantation was only significant for the IVF group (P < 0.03 for patients <30 and >35 years of age). A significant overall decrease in blastocyst formation was observed for spare embryos after ICSI versus IVF (34.2 versus 43.8%; P < 0. 05). The significance of this observation is discussed. 相似文献
9.
Rescue ICSI of unfertilized oocytes after IVF 总被引:20,自引:0,他引:20
Kuczyński W Dhont M Grygoruk C Pietrewicz P Redzko S Szamatowicz M 《Human reproduction (Oxford, England)》2002,17(9):2423-2427
BACKGROUND: Failed fertilization after IVF occurs in 10-20% of cycles. Conflicting results of rescue fertilization by ICSI have been reported. We therefore compared the success rate in terms of fertilization and pregnancy of cycles in which rescue ICSI was performed with those from a matched control group of primarily ICSI cycles. METHODS: Unfertilized oocytes from IVF cycles with total fertilization failure where at least four metaphase II oocytes were available were treated by ICSI (group I; n = 120). A matched control group was established with patients undergoing ICSI during the same period (group II; n = 280). RESULTS: Both fertilization rate and the proportion of embryos with four blastomeres on day 2 after ICSI were significantly higher in the control group (P < 0.05). Embryo quality, however, was comparable in both groups. The pregnancy rate in the control group was 25.3% whereas in group I with rescue ICSI, no pregnancy was obtained. CONCLUSIONS: Although unfertilized oocytes after IVF can be fertilized by ICSI, the developmental potential of the ensuing embryos is very poor. Therefore, rescue ICSI after total failure of fertilization is not recommended. 相似文献
10.
目的探讨冻融胚胎移植在常规体外受精(IVF)失败后补救卵胞浆内单精子注射(L-ICSI)中的应用价值。方法在12个常规体外受精失败周期中应用ICSI对未受精的MⅡ期卵子进行显微授精,将获得的优质胚胎进行冷冻,再择期行冻融胚胎移植。结果对93个未受精的MⅡ卵子接受L-ICSI,受精63枚,受精率为67.7%(63/93),异常受精3枚(2枚1PN,1枚3PN),57个正常受精卵发生卵裂,卵裂率为95.0%(57/60),优质胚胎率为43.9%(25/57),10例患者冷冻胚胎25枚,其中4例采用程序化冷冻,6例采用玻璃化冷冻。9个患者行冻融胚胎移植,共移植胚胎18枚(其中解冻后胚胎碎裂死亡5枚),其中1个周期因冻融后2个胚胎碎裂放弃移植,2例获得临床妊娠,1例分娩出正常婴儿,1例正在妊娠中,临床妊娠率为22.2%。结论 ICSI可使常规体外受精失败的卵子再受精,冻融胚胎移植可以解决胚胎与子宫内膜不同步的问题,获得相对满意的临床结局,具有一定的应用价值。 相似文献
11.
Rescue ICSI of oocytes that failed to extrude the second polar body 6 h post-insemination in conventional IVF 总被引:19,自引:0,他引:19
BACKGROUND: Attempts to 'rescue' by ICSI oocytes that remained unfertilized 24 h after conventional IVF have generally resulted in poor outcomes. The aim of the present study was to compare the outcome of rescue ICSI performed on one group of patients 6 h after initial insemination with those of another group where rescue ICSI was performed 22 h after initial insemination. METHODS: Twenty-five patient IVF cycles provided the oocytes for rescue ICSI 6 h after initial insemination, and 20 cycles provided the oocytes for rescue ICSI 22 h after initial insemination in this retrospective study. Fertilization and cleavage rates, embryo quality, implantation, and pregnancy rates after rescue ICSI were the main outcome measures. RESULTS: A fertilization rate of 70.3% was achieved with 6 h rescue ICSI compared with 48.5% with 22 h rescue ICSI (P < 0.0001). From 6 h rescue ICSI, 12 clinical pregnancies (48.0%) resulted in three sets of twins, eight singletons and one abortion. From 22 h rescue ICSI there was one (5.0%) singleton pregnancy and delivery of a healthy baby. Likewise, the implantation rate was 20.2% from 6 h rescue ICSI compared with 1.72% from 22 h rescue ICSI (P < 0.02). CONCLUSIONS: Rescue ICSI after 6 h post-insemination (46 h post-HCG) gave better fertilization, pregnancy and implantation rates compared with rescue ICSI after 22 h when oocytes have become aged. 相似文献
12.
Oehninger S.; Kruger T.F.; Simon T.; Jones D.; Mayer J.; Lanzendorf S.; Toner J.P.; Muasher S.J. 《Human reproduction (Oxford, England)》1996,11(5):1086-1089
The objective of this study was to assess fertilization, implantationand pregnancy rates in infertile patients with severe teratozoospermia[P (poor prognosis) pattern sperm morphology assessed by strictcriteria] treated by in-vitro fertilization (IVF) using a highinsemination concentration (HIC), or by intracytoplasmic sperminjection (ICSI). This was a retrospective cohort study performedin an academic tertiary institution. The outcome of 115 consecutiveICSI cycles was compared to that of a similar number of cyclesof IVF with HIC performed during a similar time frame and matchedby woman's age and basal serum (cycle day 3) follicle stimulatinghormone concentrations. The inclusion criteria were sperm morphology4% normal forms (P pattern) and 1 x106 total motile spermatozoaper ejaculate. The diploid fertilization rate in the HIC-IVFgroup was 86% and in the ICSI group 68% (P < 0.05). Importantly,an equal number of embryos was transferred to both groups ofpatients. The morphological quality of the embryos (proportionof transfers having superior morphology embryo scores) was significantlybetter in the ICSI group than in the patients receiving HIC-IVF.Although there was a clear trend for better implantation andpregnancy rates in the ICSI group, these differences were notstatistically significant We conclude that, although HIC-IVFresulted in a higher fertilization rate than ICSI in patientswith severe teratozoospermia, ICSI produced a significantlyhigher proportion of morphologically superior embryos with atendency towards a higher implantation potential. Therefore,teratozoospermic patients having adequate numbers of motilespermatozoa should be offered ICSI as an alternative to modified(HIC) IVF treatment. 相似文献
13.
The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study 总被引:12,自引:0,他引:12
Coroleu B Barri PN Carreras O Martínez F Parriego M Hereter L Parera N Veiga A Balasch J 《Human reproduction (Oxford, England)》2002,17(2):341-346
BACKGROUND: Traditionally, embryo transfer after IVF has been performed blindly and placing the embryos approximately 1 cm below the fundal endometrial surface. However, it has been suggested that transferring embryos rather lower in the uterine cavity or high in the uterus may improve implantation rates. Nevertheless, there has not yet been a controlled trial to prove this theory. This prospective randomized study investigates the influence of the depth of embryo replacement on the implantation rate after embryo transfer carried out under transabdominal ultrasound guidance. METHODS: A total of 180 consecutive patients undergoing ultrasound-guided embryo transfer were randomized to three study groups according to the distance between the tip of the catheter and the uterine fundus at the moment of the embryo deposition in the lumen of the endometrial cavity: group 1: 10 +/- 1.5 mm; group 2: 15 +/- 1.5 mm; group 3: 20 +/- 1.5 mm. RESULTS: There was equal distribution between all three study groups regarding the main demographic and baseline characteristics of the patients, ovarian response, oocyte retrieval and IVF outcome, as well as the characteristics of embryo transfer and luteal phase support. The position of the catheter tip in relation to the fundal endometrial surface in groups 1 (10.2 +/- 0.9 mm), 2 (14.6 +/- 0.7 mm) and 3 (19.3 +/- 0.8 mm) was significantly different. Implantation rate was significantly higher (P < 0.05) in groups 2 (31.3%) and 3 (33.3%) compared with group 1 (20.6%). CONCLUSIONS: The depth of the embryo replacement into the uterine cavity may influence implantation rates, and thus it should be considered as an additional procedure among factors recently proposed as associated with successful embryo transfer after IVF. 相似文献
14.
Comparison of in-vitro development of embryos originating from either conventional in-vitro fertilization or intracytoplasmic sperm injection 总被引:6,自引:0,他引:6
Dumoulin JC Coonen E Bras M van Wissen LC Ignoul-Vanvuchelen R Bergers-Jansen JM Derhaag JG Geraedts JP Evers JL 《Human reproduction (Oxford, England)》2000,15(2):402-409
In this retrospective study on 1628 consecutive cycles performed during a period of 4 years, development in vitro is compared of embryos obtained after either conventional in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). At 39-42 h after insemination or injection, embryos obtained after ICSI were significantly (P < 0.01) further developed (mean cell number 3.48 +/- 0.03) as compared with those obtained after IVF (3.22 +/- 0.03), whereas after 63-66 h of in-vitro development this difference was no longer present (mean cell number 6.11 +/- 0.15 versus 6.09 +/- 0.13 respectively). Culture of surplus embryos obtained after IVF resulted in a significantly higher (P < 0.001) mean incidence of blastocyst formation per cycle as compared with the ICSI group (31.8 +/- 1.9 versus 23.0 +/- 1.4 respectively). Blastocysts from both groups consisted of comparable numbers of cells. Blastocyst formation was also significantly higher when embryos were cultured in groups (31.2 +/- 1.8) compared to single culture (23.1 +/- 1.5; P < 0.01), in human tubal fluid (HTF) medium (29.2 +/- 1.7) compared with IVF-50(TM) medium (24.2 +/- 1.6; P < 0.01), and when they were cultured under 5% O(2) (30.3 +/- 1.5) compared with 20% O(2) (21.7 +/- 1.7; P < 0.01). In all culture conditions used, the mean incidence of blastocyst formation per cycle showed comparable differences in favour of the IVF group as compared with the ICSI group. 相似文献
15.
Payne Dianna; Flaherty Sean P.; Jeffrey Regan; Warnes Graham M.; Matthews Colin D. 《Human reproduction (Oxford, England)》1994,9(11):2051-2057
In this report, we present the results of our first 100 consecutivecycles of intracytoplasmic sperm injection (ICSI). Overall,fertilization occurred in 98% of cycles and embryos were transferredin 94% (2.6 embryos per cycle). About 50% of patients had embryosfrozen. The overall fertilization rate was 71%, of which 4%were abnormally fertilized (three pronuclei). A total of 30clinical pregnancies were established (32% per transfer), resultingin 18 singleton, six twin and one triplet ongoing pregnancies.The implantation rate per embryo was 15%. There were no significantdifferences in the fertilization or pregnancy rates betweenpatients Who had only occasional motile spermatozoa in the ejaculate,semen that was too poor for routine in-vitro fertilization (IVF),or who had failed routine IVF and/or subzonal sperm injection(SUZI). A group of 18 patients were treated with both ICSI androutine IVF on their first cycle because of the high likelihoodof failed fertilization due to poor sperm morphology (<20%normal). In this group, ICSI oocytes had a fertilization rateof 76% compared to only 15% for the routine IVF (control) oocytes,and six patients conceived after transfer of ICSI embryos (33%),indicating that ICSI can be used successfully on 50% of theoocytes if fertilization failure is expected. Similarly, patientswho had failed to become pregnant with SUZI achieved excellentresults after ICSI. There were no significant differences betweenICSI and routine IVF in the proportions of grade 1, 2 or 3 embryoson day 3 post-oocyte recovery. In conclusion, we have achievedresults comparable to those reported from Belgium and we havefound that ICSI is universally applicable to all forms of severemale factor infertility. ICSI produces fertilization, pregnancyand freezing rates comparable to routine IVF with normozoospermicsamples and has none of the drawbacks of other assisted fertilizationtechniques. 相似文献
16.
Low pregnancy rate is achieved in patients treated with intracytoplasmic sperm injection due to previous low or failed fertilization in in-vitro fertilization 总被引:14,自引:5,他引:14
Tomas C; Orava M; Tuomivaara L; Martikainen H 《Human reproduction (Oxford, England)》1998,13(1):65-70
The main indications for intracytoplasmic sperm injection (ICSI) are severe
male factor and fertilization failure or a low fertilization rate in
previous in-vitro fertilization (IVF) treatments. The fertilization and
pregnancy rates after ICSI, however, are seldom reported separately for
these two different indications. The aim of this study was to compare the
treatment outcome and pregnancy rate after ICSI between 65 patients with
previous failed fertilization or a low fertilization rate without male
factor, and 219 patients with a primary male factor. From the 2726 oocytes
collected, 2087 (77%) were micro-injected and 1355 (65%) achieved normal
fertilization. The oocyte fertilization rate was similar in the group with
previous failed fertilization or a low fertilization rate and the group
with a male factor (65 and 65% respectively), as was the cleavage rate of
normally fertilized oocytes (92 and 94% respectively). Despite the similar
fertilization and cleavage rates and the similar number and morphological
quality of embryos transferred in both groups, the pregnancy rate was
significantly lower (P < 0.05) in the group with previous failed
fertilization or a low fertilization rate than in the group with a male
factor (19.6 versus 33.5% respectively; 95% confidence intervals for the
difference, 2-26%). The implantation rate was also lower (P = 0.01) in
patients with previous failed fertilization or a low fertilization rate
(9.6%) than in the group with a male factor (19.5%). We conclude that
patients with previous failed fertilization or a low fertilization rate in
standard IVF without male factor have a significantly smaller chance of
becoming pregnant after subsequent ICSI than patients with a primary male
factor. This poor outcome probably reflects intrinsic oocyte defects not
bypassed by ICSI.
相似文献
17.
C Staessen M Camus K Clasen A De Vos A Van Steirteghem 《Human reproduction (Oxford, England)》1999,14(10):2474-2479
An auto-controlled study was conducted in couples with tubal infertility and normozoospermic semen. The fertilization rates and embryonic development in sibling oocytes treated, using the same semen sample, either by conventional in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) at the same time were compared. Sibling oocyte-cumulus complexes (OCC) of 56 different couples with tubal infertility and normozoospermic semen were randomly divided in order of retrieval into two groups inseminated either by conventional IVF or by ICSI. Of the retrieved OCC in the same cohort, 53.0 +/- 31.2 and 62.0 +/- 26.6% showed two distinct pronuclei after conventional IVF and ICSI respectively (not significant). Complete fertilization failure occurred after conventional IVF in 12.5% (7/56 couples). After ICSI, the comparable figure was 3.6% (2/56). The number of cases was too small to apply a statistical test to this difference. Total cleavage rates were quite similar: 86.7 +/- 28.0 and 90.1 +/- 21% of the zygotes developed into transferable embryos after IVF and ICSI respectively (not significant). Similarly, no difference in embryo quality was observed. Although injection and insemination of the oocytes were performed at the same time in the two groups, at 42 h post-insemination more embryos were at the four-cell stage after ICSI (P < 0.001) than after conventional IVF, where more embryos were still at the two-cell stage (P < 0.02). Embryo transfer was possible in all 56 couples, resulting in 16 positive serum human chorionic gonadotrophin tests (28.6% per embryo transfer), from which a clinical pregnancy resulted in 15 couples. The best embryos were selected for transfer independently of the insemination procedure, but preferably from the same origin. There appeared to be no difference in implantation potency of the embryos obtained with either technique after the non-randomized transfers. 相似文献
18.
Fishel S Aslam I Lisi F Rinaldi L Timson J Jacobson M Gobetz L Green S Campbell A Lisi R 《Human reproduction (Oxford, England)》2000,15(6):1278-1283
The objective of this study was to examine different clinical scenarios of in-vitro conception, viz. fertilization with conventional IVF, IVF with high insemination concentration (HIC) and intracytoplasmic sperm injection (ICSI), and assess on a sibling oocyte comparison the hypothesis that ICSI should be performed in all cases requiring in-vitro conception. ICSI with husband's spermatozoa had a higher incidence of fertilization as compared with IVF or IVF with HIC with donor spermatozoa (if previous failure of fertilization had occurred) for unexplained infertility. Similarly, ICSI with husband's spermatozoa had as high an incidence of fertilization as IVF with donor spermatozoa for patients with severe oligozoospermia, asthenozoospermia and/or teratozoospermia, even when the spermatozoa were not selected for their morphology. Two studies were performed to assess ICSI in potential oocyte-related failure of IVF, viz. when fertilization occurred in >50% of oocytes for one group of patients, and in <50% of oocytes in a second group. In both of these studies a significant proportion of the oocytes that failed to fertilize with conventional IVF eventually fertilized after ICSI. The overall conclusion was that ICSI as a first option offers a higher incidence of fertilization, maximizes the number of embryos and minimizes the risk of complete failure of fertilization for all cases requiring in-vitro conception. However, among other concerns, current knowledge of ICSI as an outcome procedure does not provide the confidence to use this process in all cases of IVF for the time being. 相似文献
19.
JIN HYUN JUN CHUN KYU LIM YONG SEOG PARK HO JOON LEE YOU SIK LEE JU TAE SEO IL PYO SON INN SOO KANG 《American journal of reproductive immunology (New York, N.Y. : 1989)》1997,37(4):310-314
PROBLEM: To evaluate the efficacy of intracytoplasmic sperm injection (ICSI) treatment in the immunological infertile patients. METHODS: The subjects were 60 cycles of 44 immunological infertile patients and these clinical data were analysed, retrospectively. They were classified into female and male immunological infertility group and were treated with conventional IVF, ICSI, and half-ICSI. RESULTS: The fertilization rate of ICSI (60.3%) and half-ICSI (60.7%) cycles were significantly (P<0.01) higher than conventional IVF (42.6%) cycles. In the male immunological infertility group, fertilization rate was significantly (P<0.01) higher in ICSI (60.7%) and half-ICSI (66.7%) cycles than in conventional IVF (27.4%) cycles and clinical pregnancy rate was higher in ICSI (54.5%) and half ICSI (33.3%) than in conventional IVF (25.0%) cycles. CONCLUSIONS: We suggest that ICSI treatment is highly effective method to improve fertilization and pregnancy rate in IVF-ET program of male immunological infertility. 相似文献
20.
Gorayeb R Borsari AC Rosa-e-Silva AC Ferriani RA 《Behavioral medicine (Washington, D.C.)》2012,38(2):29-35
The study's objective was to assess the effect of a cognitive behavioral group intervention on the pregnancy rates of patients submitted to in vitro fertilization (IVF) techniques or to intracytoplasmic sperm injection (ICSI). The study was conducted on 188 patients, 93 who participated in a group of psychological intervention before the IVF and ICSI procedures and 95 patients submitted to IVF and ICSI during the same period of time, who did not participate in the intervention (control group). Clinical pregnancy was the outcome measure. Demographic and clinical variables were compared between groups in order to assess the group's homogeneity. Participants in the psychological intervention obtained a pregnancy rate of 39.8%, significantly higher than the 23.2% rate of nonparticipants (χ(2) = 6.03, p = .01, odds ratio of 22 (CI: 1.16-4.13). The data suggest that group psychological intervention before IVF and ICSI in order to control stress seems to increase the rate of success of these procedures. 相似文献