供精IVF中不同授精浓度及方式对临床结局的影响

目的:探讨供精IVF-ET中较为合适的授精浓度及不同授精方式对临床结局的影响。方法:回顾性分析2013年1月-2016年6月行供精IVF治疗的542个周期的资料,根据不同授精浓度分为3组:A组为(1.0~2.0)×10~6/ml,B组为(2.0~4.0)×10~6/ml,C组为(4.0~8.0)×10~6/ml。比较各组间受精率、多精受精率、卵裂率、优质胚胎率、种植率、临床妊娠率及流产率的差异,并与同期供精ICSI周期进行比较。结果:(1)3组间受精率、卵裂率、优质胚胎率、种植率、临床妊娠率和流产率均无统计学差异(P0.05),但B组和C组的多精受精率高于A组(5.66%、5.79%、2.69%,P0.05)。(2)通过与供精ICSI组进行比较,在供精精液可行IVF受精的情况下,ICSI并不能提高供精患者的优质胚胎率和临床妊娠率。结论:供精授精浓度在(1.0~2.0)×10~6/ml时可获得较高的受精率、种植率和临床妊娠率,提高授精浓度只增加多精受精率而不改善临床结局,此时选择ICSI助孕并不提高优质胚胎率和临床妊娠率。

Influence of different sperm concentration for insemination and fertilization methods on clinical outcomes of patients when undergone IVF used donor spermatozoa

Objective:To explore the optimal sperm concentration for insemination when patients undergone vitro fertilization-embryo transfer(IVF-ET)used donor sperm by compared the influence of different sperm concentration for insemination on rate of fertilization,and to explore the influence of fertilization methods on clinical outcomes by compared with intracytoplasmic sperm injection (ICSI) used donor spermatozoa.Methods:The date of 542 cycles of routine IVF used donor spermatozoa from January 2013 to June 2016 was retrospectively analyzed.The subjects were in three groups according to the different sperm concentrations for insemination,which included that subjects in group A used sperm concentration were(1.0-2.0) × 106/mL,patients in group B used sperm concentration were(2.0-4.0)× 106/ mL,and patients in group C used sperm concentration were(4.0-8.0)× 106/mL.Fertilization rate,polyspermy fertilization rate,cleavage rate,quality embryo rate,implantation rate,pregnancy rate and abortion rate were compared among the three groups.The distinction of clinical outcomes were also compared between the patients experienced IVF-ET and the subjects experienced ICSI).Results:① There was no significant difference in fertilization rate,cleavage rate,quality embryo rate,implantation rate,pregnancy rate and abortion rate among the three groups(P ＞ 0.05).However,the polyspermy fertilization rate of patients in group B and group C were significantly higher than those of patients in group A(5.66 ％,5.79 ％ VS 2.69 ％,P ＜ 0.05).②when the number of donor spermatozoa was enough for routine IVF,ICSI could not improve quality embryo rate and pregnancy rate.Conclusion:Optimizated sperm insemination concentration for IVF-ET when donor sperm concentration were(1.0-2.0)× 106/mL,fertilization rate,implantation rate and pregnancy rate are high.Increasing the sperm concentration of insemination cannot improve the clinical outcomes,but maybe increase the risk of polyspermy fertilization.ICSI can not increase the quality of embryo and pregnancy rate when donor spermatozoa is enough for IVF.