对前次体外受精失败患者行half-ICSI的临床结局分析

目的:探讨体外受精（IVF）失败患者后续性治疗时行部分卵胞浆内单精子显微注射（half-ICSI）以及ICSI治疗的结局差异。 方法:回顾性分析2007年1月—2009年l2月在我中心进行辅助生殖技术，选取前次IVF受精失败（包括完全受精失败和受精低下，即受精率为0和低于25%），在随后周期中行Half-ICSI治疗的8个周期作为研究组，简称后续性half-ICSI组，同时因前次IVF受精失败在随后治疗周期采取全部卵行ICSI方法受精的16个周期（后续性ICSI组）的治疗结局作为对照组。 结果: 后续性half-ICSI组总的受精率显著低于后续性ICSI组(51.79% vs 67.81%，P<0.01)，后续性half-ICSI组卵裂率，优胚率，植入率，妊娠率，流产率与后续性ICSI组相比均无显著性差异。妊娠率两组分别为50%，25.0%，流产率分别为0，6.2%。后续Half-ICSI组中IVF受精率显著低于ICSI的受精率(29.82% vs 74.55%) (P<0.001)。结论: IVF受精失败将影响后续性IVF治疗的受精率，但是IVF受精失败并不是ICSI治疗的绝对指征，考虑到安全性，Half-ICSI治疗优于ICSI治疗。

Clinical analysis of half-ICSI to the previous fertilization failure after conventional in vitro fertilization

Objective: To analyze the clinical outcome of subsequent half- intracytoplasmic sperm injection (half-ICSI) or subsequent ICSI in patients with fertilization failure after conventional IVF. Methods: Data from 8 subsequent half-ICSI cycles with the fertilization failure and low fertilization (defined as lower than 25% fertilization) after conventional IVF between January 2007 and December 2009 were retrospectively analyzed, and data from 16 subsequent-ICSI cycles at the same time as the control group. Results: The total fertilization rate in subsequent half-ICSI group was significantly lower than that in subsequent-ICSI group（51.79% vs 67.81%, P<0.01), And cleavage rate, good quality embryo rate, implantation rate, pregnancy rate and abortion rate had no significant differences between the two groups. Pregnancy rate was 50% and 25.0%, respectively, abortion rate was 0 and 6.2%, respectively. The IVF fertilization rate in subsequent half-ICSI group was significantly lower than that in subsequent-ICSI group (29.82% vs 74.55%)(P<0.001).Conclusion: The fertilization rate in subsequent IVF treatment because of the history of fertilization failure after IVF, but fertilization failure was not the absolute indication for ICSI treatment. Half-ICSI was better than ICSI considering the safty.