体外受精失败后行单精子卵胞浆内注射获成功妊娠分娩

LIVE BIRTH AND NORMAL OFFSPRING AFTER TRANSFER OF EMBRYOS FROM RESCUE INTRACYTOPLASMIC SPERM INJECTION.

目的:探讨常规体外受精-胚胎移植(IVF-ET)受精失败后,对未受精卵母细胞进行补救性单精子卵胞浆内注射(ICSI)治疗的可行性和安全性。方法:超促排卵获得的卵子进行常规体外受精,16小时后对全部或>70%卵母细胞未受精的病例,进行补救ICSI,所获得的优质胚胎进行宫腔内移植。结果:7例患者51枚未受精卵母细胞行补救ICSI后,受精37枚,卵裂30枚,优质胚胎17个,受精率72.5%,卵裂率81%,与20例单纯行ICSI治疗者比较,受精率、卵裂率无统计学显著性差异。补救ICSI组1例获临床妊娠,并分娩健康新生儿,随访1年余未发现异常,临床妊娠率(14.3%)较单纯ICSI组(35%)显著降低(P<0.01)。结论:常规体外受精-胚胎移植受精失败后,对未受精卵母细胞进行补救性ICSI,有机会获得健康新生儿。

Objective:To investigate the feasibility and security of rescue intracytoplasmic sperm injection(ICSI) after complete fertilization failure during in vitro fertilization(IVF) cycle.Method:Unfertilized oocytes from IVF cycles with completely or almost completely fertilization failure were performed reinsemination by ICSI 16 h after initial insemination.Fertilization and cleavage rates,embryo quality and pregnancy rates after rescue ICSI were the main outcome measures.There results were compared with those of 20 patients who used ICSI as the only insemination technique.Results:51 unfertilized oocytes from 7 patients were treated with ICSI.A fertilization and cleavage rate of 72.5%and 81%was achieved with rescue ICSI,and the rate of 74.5%and 91.5%was achieved with ICSI as the only insemination technique.One clinical pregnancy(14.3%) resulted in a healthy newborn in rescue ICSI group.Conclusion:Rescue ICSI can be used successfully and result in the delivery of healthy offspring.