不明原因不孕患者体外受精方式的探讨

目的探讨不明原因不孕患者行首次体外受精(IVF)治疗时受精方式的选择。方法对2004年6月至2005年12月在北京大学第三医院行IVF治疗的35例不明原因不孕患者,将其卵母细胞分为2组,同时行常规受精和卵胞浆内单精子注射受精(ICSI),比较2组的受精结局、妊娠率及着床率。结果常规受精组受精率(51.2%)低于ICSI组(61.3%),差异有统计学意义(P<0.05);而完全受精失败率(20.0%)明显高于ICSI组(2.8%),差异有统计学意义(P<0.05);2组的优质胚胎率、临床妊娠率、着床率差异无统计学意义。结论不明原因不孕患者行首次IVF治疗时,采用部分卵母细胞常规受精、部分卵母细胞ICSI的方法,可降低完全受精失败风险。

Methods of insemination for couples with unexplained infertility undergoing in vitro fertilization

Objective To analyze the outcome of conventional IVF and ICSI in sibling oocytes in patients diagnosed with unexplained infertility and to determine an optimal insemination technique.Methods In 35 couples with unexplained infertility undergoing IVF between Jun 2004 to Dec 2005 in Peking University Third Hospital,sibling oocytes were randomized into conventional IVF or ICSI insemination.Fertilization rate and embryo quality were compared between IVF- and ICSI-inseminated oocytes.Result A significantly better fertilization rate was obtained after ICSI as compared with conventional IVF(61.3% versus 51.2%)(P< 0.05),and total fertilization failure following ICSI and IVF treatment was seen in 2.8% and 20.0% of the cycles respectively(P< 0.05).There was no statistically significant difference in embryo quality,pregnancy rate and implantation rate between the IVF and ICSI groups.Conclusion In the first IVF cycle of couples with unexplained infertility,splitting the sibling oocytes by IVF and by ICSI can effectively minimize complete fertilization failure.