在体外受精失败周期中应用卵母细胞质内精子注射的探讨

目的　研究卵母细胞质内精子注射（ｉｎｔｒａｃｙｔｏｐｌａｓｍｉｃ　ｓｐｅｒｍ　ｉｎｊｅｃｔｉｏｎ，ＩＣＳＩ）技术用于体外受精失败后的补救措施在临床治疗中的应用。方法　采用卵母细胞质内精子注射（ＩＣＳＩ）技术对体外受精失败的卵子行“再授精”补救，选择外观形态正常的早期胚胎进行宫腔内移植。结果　１４个体外受精失败周期中共有１２７个未受精ＭＩＩ卵采用卵母细胞质内精子注射（ＩＣＳＩ）技术进行“再授精”补救。其中１０５个卵子（８２．７％）注射后正常存活；７１个卵子（５５．９％）正常受精；１５个卵子（１１．８％）为多原核（３原核）受精卵。６１个正常受精卵（８５．９％）发生卵裂。１３个移植周期共移入早期胚胎３２个，获１例临床妊娠（７．７％）。结论　采用卵母细胞质内精子注射（ＩＣＳＩ）技术对体外受精失败后的卵子进行“再授精”作为一种诊断及治疗手段具有一定的临床应用价值，但胚胎移植后的妊娠率较低。

Evaluation of the Clinical Use of Intracytoplasmic Sperm Injection after Fertilization Failure in vitro

Objective To evaluate the clinical use of intracytoplasmic sperm injection when fertilization cycles in vitro failed. Methods Reinsemination by using of intracytoplasmic sperm injection was carried out 24 h after oocytes retrieval in the failed fertilization cycles in vitro. Results A total of 127 one-day-old Mu oocytes from 14 failed fertilization cycles in vitro were subjected to intracyto- plasmic sperm injection. Among them, 105 were survived(82. 7%), 15 polyploidic (11. 8%), and 71 (55. 9%) fertilized normally, of which, 61(85.9%) cleaved. Thirty-two embryos were trans- ferred to 13 patients. One patient (7.7%) conceived after ET. Conclusions Intracytoplasmic sperm injection can be used when fertilization cycles in vitro failed for either diagnostic or thera- peutic purpose, but the pregnancy rates seems not high.