卵胞浆内单精子注射在常规体外受精失败病例中的应用

目的评价卵胞浆内单精子注射(ICSI)对常规体外受精(IVF)失败病例的应用效果。方法对于常规IVF受精失败的病人在第2天进行补救ICSI(A组)21个周期,或在下一个周期直接应用ICSI技术治疗(B组)18个周期。分别与因严重少、弱精子症而行ICSI的243周期(对照组)的受精率、优质胚胎率和妊娠率等进行比较。结果A组的受精率、卵裂率、优质胚胎率分别为61.53%、81.73%、72.94%,均比B组的83.87%、97.69%、84.25%显著降低(P<0.05),而两组的多原核率差异无显著性(3.55%vs1.29%,P>0.05)。比较临床妊娠率、种植率和冷冻周期率,B组与对照组均无显著差异,而A组与对照组均有显著差异。结论常规IVF受精失败者可通过第2天补救ICSI或下一周期直接行ICSI而提高受精率和种植率,而后者比前者能获得更好的妊娠结局。

Clinical value of intracytoplasmic sperm injection for patients with fertilization failure in conventional in vitro fertilization

Objective To evaluate the clinical outcome of intracytoplasmic sperm injection(ICSI)in patients with fertilization failure after conventional in vitro fertilization(IVF).Methods Date were collected and compared between 21 rescue intracytoplasmic sperm injection(group A)or 18 late ICSI cycles(group B)with history of conventional IVF complete failure of fertilization,243 ICSI cycles because of male factor(control group).Results There was significant difference between group A and group B in the normal fertilization rates(61.53% vs 83.87%,P<0.01),cleavage rates(81.73% vs 97.69%,P<0.01),good quality embryo rates(72.94% vs 84.25%,P<0.05).There was no statistically difference (3.55% vs 1.29%,P>0.05)in multi-nucleus rates.Regarding to pregnancy rates,implantation rates and frozen embryo cycle rates,there were no significant differences between the group B and the control group.However,there is signifi- cant different between group A and the control group.Conclusion r-ICSI and ICSI can improve the fertilization and implan- tation outcome of patients with fertilization failure,and the latter has better pregnancy outcome than the former.