同周期同胞卵研究较早期实施补救ICSI价值的探讨

目的:比较同周期同胞卵不同时间补救卵细胞浆内单精子显微注射(ICSI)的结果。方法:选取常规体外受精(IVF)治疗失败的26个周期312枚卵子(每周期未受精卵≥8枚,受精率<25%),分为两组:观察组受精后8h实施补救ICSI,对照组20h实施补救ICSI,对比两组受精率、优质胚胎形成率、囊胚形成率。结果:观察组和对照组受精率分别为81.4%、74.36%,两者差异无统计学意义(P>0.05),观察组优质胚胎形成率和囊胚形成率分别为48.82%、38.58%,明显高于对照组的33.62%,22.41%(P<0.01)。结论:对常规IVF受精失败及受精率较低的周期受精后8h实施补救ICSI得到的结果优于受精后20h的结果。

Study on the clinical value of earlier period rescue ICSI of sibling oocytes in the same cycle

Objective:To compare the results of reinsemination by rescue ICSI on unfertilized oocytes from the same patients in the same conventional IVF cycle at different time and to evaluate the outcome of rescue ICSI.Methods:There were 312 unfertilized oocytes from 26 conventional IVF cycles,in each cycle the number of unfertilized oocytes≥8 and the rate of fertilization<25%.These unfertilized oocytes were devided into two groups:the unfertilized oocytes which were reinseminated 8h after conventional IVF insemination as the observation group;those unfertilized oocytes whose reinsemination were performed 20h after conventional IVF insemination as the control group.The rate of fertilization and formation of high quality embryo and blastocyst between the two groups was compared.Results:The rate of fertilization in the observation group and control group was 81.4% and 74.36% respectively(P>0.05).The formation rates of high quality embryo and blastocyst in the observation group were 48.82% and 38.58% respectively,which were higher than those(33.62% and 22.41%,respectively) in the control group(P<0.01).Conclusion:The reinsemination by ICSI performed 8h after conventional IVF insemination is a more effective measure to rescue than 20h in the case of total or near total fertilization failure in the conventional IVF.