常规体外受精失败周期早补救卵胞浆内单精子注射与部分-卵胞浆内单精子注射受精方式的回顾性分析

Use of early rescue ICSI and half-ICSI insemination methods in patients with routine in vitro fertilization failure:a retrospective comparative analysis

目的比较早补救卵胞浆内单精子注射(ICSI)与部分(Half)-ICSI两种授精方式在体外受精(IVF)助孕中的应用。方法回顾性分析76个常规IVF发生受精失败的移植周期。其中30个周期为早补救ICSI授精方式(早补救ICSI组),46个周期为Half-ICSI授精方式(Half-ICSI组)。分析受精情况、胚胎质量、种植率、妊娠率、抱婴回家率、出生缺陷和卵母细胞利用情况。结果早补救ICSI组与Half-ICSI组的双原核(2PN)受精率、多PN受精率、1PN受精率、优质胚胎率、胚胎种植率、妊娠率、抱婴回家率、出生缺陷无显著差异(P>0.05)。但早补救ICSI组卵母细胞利用率高于Half-ICSI组,平均受精卵数分别为(6.30±2.96)和(4.20±1.75)(P<0.001),胚胎数分别为(6.20±2.89)和(4.11±1.68)(P<0.001),冷冻胚胎数分别为(3.20±2.76)和(1.56±1.68)(P<0.01)、冷冻周期率分别为76.67%和50.00%(P<0.05)。结论在常规IVF完全受精失败的周期,早补救ICSI授精方式与Half-ICSI授精方式的受精率、胚胎质量和妊娠结局类似,但前者有更好的卵母细胞利用率和更多可利用胚胎。

Objective： To retrospectively compare the outcome of early rescue ICSI and half-ICSI insemination methods in patients with routine in vitro fertilization failure. Methods. Seventy six patients with routine in fertilization failure and primary infertility, whose tubes did not completely obstructed, participated in the study. Thirty patients received early rescue ICSI （early rescue ICSI group） and 46 patients received half-ICSI （half-ICSI group）. The rates of fertilization, cleavage, embryo quality, implantation, pregnancy, take baby home, birth defect and the utilization of oocyte were compared between the two groups. Results： The rates of 2PN fertilization, multiple PN fertilization, high quality embryo, implantation, pregnancy,take baby home and birth defect were not significantly different between two groups （P〉 0.05）. The number of fertilization oocytes was 6.30±2.96 and 4.20±1.75 respectively（P〈0. 001）. The number of embryos was 6. 20±2. 89 and 4. 11 ± 1. 68 （P〈0. 001）. The number of embryos for cryopreservation was 3.20±2.76 and 1.56±1.68（P〈0.01）. Frozen embryo cycle rates were 76.67% and oocyte and subsequently had more embryos to use.