常规体外受精失败后6h补行卵胞浆内单精子注射及其严格指征的临床意义

目的探讨为进一步严格控制卵胞浆内单精子注射（ICSI）指征，在常规体外受精（IVF）失败后6h补行ICSI的方法对临床结果的影响。方法回顾分析本中心2006年1月至2007年11月常规IVF或ICSI的方法进行的治疗周期（A组）与2007年12月至2008年11月修改ICSI指征后，使用常规IVF及受精失败后6h补行ICSI的方法进行的治疗周期（B组）比较两个时期的总周期的临床妊娠率和ICSI所占比例。结果A组799周期，临床妊娠率为35．29％，其中行ICSI369例，占总周期46．18％；B组704周期，临床妊娠率为42．19％，其中行ICSI190例，占总周期26．99％。两组的总临床妊娠率有显著性差异，行ICSI的比例也有显著性差异（P〈0．05）。结论使用常规IVF受精失败后6h补行ICSI的方法，修改ICSI指征，ICSI比例降低，对本中心的临床妊娠率无影响。

Study on the clinical value of rescue ICSI 6 h post-IVF failure and restricting the indication of ICSI

Objective： To study the effects of restricting the indication of ICSI and rescue ICSI 6 h post-IVF failure on clinical outcome. Methods： We used conventional IVF or ICSI from Jan. 2006 to Nov. 2007（Group A） ; and from Dec. 2007 to Nov. 2008, used the conventional IVF and rescue ICSI 6 h post-IVF（Group B） to modify the indications for ICSI in our hospital; and then compared the proportion of ICSI and the clinical pregnancy rate between two groups. Results： In group A, clinical pregnancy rate was 35.29% in total 799 cycles, of which ICSI 369 cases, accounting for 46.18%. While in group B, clinical pregnancy rate was 42. 19% in 704 cycles, of which rescue ICSI 190 cases, 26.99% of the total cycles. The total clinical pregnancy rates were significantly different between these two groups, the proportion of ICSI are also significant different （P〈0.05）. Conclusions： After the use of rescue ICSI 6h post-IVF failure and modification of ICSI indication, ICSI ratio was decreased, but no effect on clinical pregnancy rate was found.