女性原发不孕3种体外受精方式效果比较

目的:探讨女性原发不孕患者行体外受精(IVF)、卵细胞浆内单精子注射(ICSI)和50IVF加50ICSI3种受精方式对受精率和胚胎发育潜能的影响,为是否扩大ICSI的应用指征提供依据。方法:回顾性分析163个周期女性原发性不孕患者体外助孕资料,分为A组(119个IVF-ET周期)、B组(29个ICSI周期)、C组(15个50IVF加50ICSI周期),对3组患者的一般情况、促排卵过程中卵巢反应性指标、受精、胚胎质量和妊娠情况进行分析。结果:A组的每获得卵受精率明显高于C组和B组,差异有统计学意义(P=0.000),但3组的受精率、正常受精率差异无统计学意义。3组>4细胞胚胎、细胞碎片<20的胚胎和优良胚胎比率以及妊娠率差异均无统计学意义(P>0.05)。A组的完全受精失败率为6.72(8/119),而另外两组均无完全受精失败发生。结论:ICSI不能改善女性原发不孕患者的体外助孕临床结局,ICSI的扩大应用应慎重。

Comparative Analysis on the Effects of 3 Fertilization Methods for Female Primary Infertility

Objective:To determine the effects of in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI) and half-IVF associated with half-ICSI on the fertility rate and embryonic development potentiality among female primary infertility,and to provide evidences for whether to extend the application indicatios of ICSI.Methods:In a retrospective study,the assisted gestation information of 163 cycles among female primary infertility patients were categorized as follows:group A(IVF-ET,n=119),group B(ICSI,n=29),and group C(half-IVF and half-ICSI,n=15).The general state,ovary responsivity index during the process of ovulation induction,fertility rate,embryo quality,and pregnancy rate were recorded and compared among the 3 groups.Results:The fertility rates per oocyte retrieved in group A were obviously higher than group B and C,with the statistical significance(P=0.000),although the differences of fertility rates and normal fertility rates showed no statistical significance among the 3 groups.The differences of the ratio(embryos with >4 cells and <20% cell debris compared with good embryos) and pregnancy rate were not statistically significant(P>0.05).The fertilization failure rate in group A was 6.72%(8/119),and no fertilization failure occurred in the other 2 groups.Conclusion:Our results show that the use of ICSI can't improve the clinical outcome of assisted gestation for female primary infertility,and then the expansion of ICSI application is not recommended.