常规体外受精失败的相关因素分析

目的探讨常规体外受精一胚胎移植（IVF—ET）治疗中受精失败（包括全卵受精失败和受精率低于30％）的相关影响因素。方法回顾性分析2009年9月至2012年12月在唐山市妇幼保健院生殖中心接受IVF．ET治疗的1339个周期。根据受精率情况分为全卵受精失败组（A组）82例，受精障碍组（B组，受精率〈30％）116例与受精正常组（C组，受精率〉30％）1141例进行比较，分析三组的女方年龄、促排卵方案、获卵数、卵子成熟率、不孕原因等情况。结果A、B两组患者的年龄、不孕年限、促排卵方案、获卵数、卵子成熟率与C组比较差异无统计学意义，但是不明原因性不孕比率明显高于C组，原发不孕并伴有男方因素患者受精失败危险性明显增高。结论不明原因性不孕、原发不孕并伴有男方精子因素包括少、弱、畸精子症，精子功能缺陷等的患者在行体外受精（IVF）助孕时存在较大受精失败的风险。

Analysis of the facors related to the failure of routine IVF fertilization

Objective To examine the causes of total fertilization failure and low in vitro fertilization rate and embryo transplantation （IVF-ET）. Methods 1 339 IVF-ET between September 2009 and December 2012 were included in this study.The cases were divided into total fertilization failure group （group A, 82 cases）, low fertilization rate group （group B, 116 cases） and fertilization normal group （group C, 1 14l cases） according to the fertilization rate. The female age, duration of infertility, ovarian stimulation protocol, oocyte retrieval, rate of oocytes maturation and the causes of infertility among the three groups were compared. Results There were no differences between the female age,duration of infertility, ovarian stimulation protocol, oocyte retrieval, and rate of oocytes maturation. The rate of failure of fertilization was high in the primary infertility patients.The fertilization failure was higher in primary infertility than in the unexplained infertility patients and other cause infertility accompany by mild-moderate male factors. Conclusion Unexplained causes of infertility and male factors （e.g low sperm count, abnormal form of sperms） were the causes of failure in IVF-ET.