严重少精子症患者行卵胞浆内单精子注射治疗单个取卵周期累积活产率分析

目的分析严重少精子症患者行卵胞浆内单精子注射(ICSI)治疗的单个取卵周期累积活产率。方法回顾性分析2014年1月至2019年9月在本院生殖医学科因男方严重少精子症为主要指征接受ICSI治疗的187对不育夫妇的临床资料,其中8对夫妇伴有男方染色体异常,单独列出分析。将最终纳入的179对夫妇的240个取卵周期按照女方年龄分为≤35岁、36～39岁、≥40岁组;按照获卵数不同分为≤5枚、6～10枚、11～15枚、≥16枚组,比较各组的移植胚胎情况及累积临床妊娠率和累积活产率。结果 179对夫妇目前的单个取卵周期累积活产率为50.00%(96/192)。≤35岁组、36～39岁组、≥40岁组的获卵数、可利用胚胎数、累积临床妊娠率及活产率比较均有显著性差异(P<0.05),随着女方年龄的增加,获卵数、可利用胚胎数、累积临床妊娠率及累积活产率均呈下降的趋势。不同获卵数组间比较,随着获卵数的增加,可利用胚胎数显著增加(P<0.05)。获卵数≥6枚的各组与≤5枚组比较,女方年龄、无可利用胚胎率、平均移植胚胎数、平均移植优胚数、累积临床妊娠率、累积活产率均显著升高(P<0.05)。获...

Cumulative live birth rate per oocytes retrieved cycle of patients with severe oligospermia undergoing ICSI treatment

Objective:To explore the cumulative live birth rate per oocytes retrieved cycle of intracytoplasmic sperm injection(ICSI)for the patients with severe oligospermia.Methods:The clinical data of 187 infertile couples who received ICSI treatment due to male severe oligospermia in the Department of Reproductive Medicine of our hospital from January 2014 to September 2019 were retrospectively analyzed.Among them,eight couples were accompanied by male chromosome abnormalities,which were listed and analyzed separately.The 240 oocytes retrieval cycles of the 179 couples were finally included.According to the age of the woman,they were divided into≤35,36-39 and≥40 years old group.According to the number of oocytes collected,they were divided into≤5,6-10,11-15 and≥16 group.The embryo transfer status,cumulative clinical pregnancy rate and cumulative live birth rate were compared among the groups.Results:The cumulative live birth rate of 179 couples per oocytes retrieval cycle was 50.00%(96/192).There were significant differences in the number of oocytes retrieved,the number of available embryos,the cumulative clinical pregnancy rate and the live birth rate among the≤35,36-39 and≥40 year old group(P<0.05).The number of oocytes retrieved,the number of available embryos,the cumulative clinical pregnancy rate,and the cumulative live birth rate all show a downward trend along with the increase of woman age.Comparing the groups with different number of oocytes retrieved,the number of available embryos increased significantly as the number of oocytes retrieved increased(P<0.05).The age of woman,the rate of unavailable embryos,the average number of embryos transferred,the average number of embryos transferred,the cumulative clinical pregnancy rate,and the cumulative live birth rate in the groups with number of oocytes retrieved≥6 were significantly increased comparing the groups with number of oocytes retrieved≤5(P<0.05).When the number of oocytes retrieved≤5,the cumulative clinical pregnancy rate and cumulative live birth rate in≤35 year old group were significantly higher than those in>35 year old group(P<0.05).After receiving genetic counseling,8 couples with chromosomal abnormalities were required to undergo ICSI treatment.A total of 13 oocyte retrieval cycles were performed.Five couples obtained clinical pregnancy,4 couples had full-term delivery,1 couple delivered 1 baby boy,and the remaining 3 couples delivered 1 baby girl respectively.Conclusions:The pregnancy outcome of the couples with male severe oligospermia receiving ICSI treatment is related to the woman’s age and number of oocytes retrieved.Therefore,it is recommended that such patients should receive assisted pregnancy treatment as soon as possible.Patients with male chromosomal abnormalities should be given genetic counseling to minimize the genetic risk.