部分ICSI在体外受精胚胎移植中预防受精失败临床效果

目的探讨部分ICSI(half-ICSI)在IVF-ET中预防受精失败的临床价值。方法回顾性分析2010年3月至2013年3月在本院生殖中心行half-ICSI治疗的77例患者(77个周期)。在77个周期中,一半卵母细胞行常规IVF受精,一半卵母细胞行ICSI治疗。在行half-ICSI患者中,以行IVF的一半卵母细胞是否正常受精进行分组:受精失败组(A组,31例)和受精正常组(B组,46例),对比两组患者的女方年龄、不育年限、不育原因、获卵数、成熟卵比例、优质胚胎率、种植率及妊娠率和临床累积妊娠率,同时比较两组ICSI的正常受精率及异常受精率。结果77个周期中常规IVF的受精率低下占40.2%(31/77),其中完全受精失败占25.9%(20/77)。受精失败组的不育年限比正常受精组长,差异有统计学意义(P0.05)。两组的女方年龄、不育原因、获卵数、成熟卵比例、优质胚胎率、临床累积妊娠率相比较,差异均无统计学意义(P0.05)。常规IVF受精失败组的胚胎移植数多于受精正常组,差异有统计学差异(P0.05),但两组的种植率及妊娠率差异无统计学意义(P0.05)。两组中ICSI的正常受精率和异常受精率差异均无统计学意义(P0.05),但B组的可用胚胎数多于A组,两组差异有统计学意义(P0.05)。结论对于原发不育年限较长,且无明确不育原因的患者可选择行half-ICSI受精方式,其不仅能有效防止受精失败,还能获得较理想的妊娠结局,这是预防受精失败行之有效的方法之一。

Clinical research of using half-ICSI to prevent fertilization failure in IVF

Objective. To investigate the clinical value of half-intracytoplasmic sperm injection（ICSI）in prevention of fertilization failure in IVF. Methods： A total of 77 cycles undergone half-ICSI in our center from March 2 010 to March 2 013 were included in this study. In 77 cycles,half of oocytes were fertilized by routine IVF,and half by ICSI. They were divided into fertilization failure group （31 cycles）, and fertilization normal group（46 cycles） according to the fertilization results of IVF. The female age, duration of infertility, cause of infertility, oocyte retrieval,mature ooeytes rate, and high quality embryo rate, implantation rate and pregnancy rate were compared between the two groups. At the same time,the rates of normal and abnormal fertilization of ICSI were compared between the two groups. Results： The rate of low fertilizat （20/77）in 77 cycles. The duration of that in normal fertilization group （P~ ion was 40.2 % （31/77）and total fertilization failure rate was 25.9 infertility in fertilization failure group was significantly longer than 0.05）. There were no significant differences in the female age,cause of infertility, oocyte retrieval, mature oocytes rate, high quality embryo rate, and clinical cumulative pregnancy rate between the two groups（P〉0.05）. The number of transplanted embryo in fertilization failure group was significantly more than that in normal fertilization group（P〈0.05）, but no significant difference in rate of implantation and pregnancy between the two groups （P〉0.05）. There was no significant difference in normal and abnormal fertilization rates with ICSI between the two groups （P〉 0.05）,but the number of available embryos from normal fertilization group was significantly more than that in the fertilization failure group（P〈0. 05）. Conclusions. For primary unexplained infertility, the patients who have longer duration of infertility should be selected for half-ICSI method,which can not only prevent fertilization failure effectiv