卵母细胞浆内单精子显微注射技术的临床应用

Research on the clinical application of intracytoplasmic sperm injection

目的:研究卵母细胞浆内单精子显微注射(ICSI)技术的临床应用价值及影响ICSI成功率的因素。方法:对接受ICSI技术治疗的69例男性因素不育、不明原因不孕及体外受精失败患者75个周期的病例资料进行回顾分析。结果:对750个成熟卵母细胞进行ICSI操作,正常受精530个,受精率70.67%;25例临床妊娠,临床妊娠率33.33%。2003～2004年ICSI的受精率和卵裂率均显著高于2001～2002年(68.53%Vs75.86%;89.19%Vs95.45%)。女方三个不同年龄组间的受精率、种植率及临床妊娠率存在显著性差异。体外受精失败组受精率显著下降。结论:ICSI技术是治疗不孕不育症的有效方法,其治疗结局受卵子质量、女方年龄及ICSI操作技术等因素的影响。

Objective：To research on the clinical application of intracytoplasmic sperm injection （ICSI） and to analyze the factors influencing the outcome of ICSI. Methods：69 couples received ICSI in treatment of male infertility, idiopathic infertility and in vitro fertilization failure. Seventy-five cycles in 69 cases from August 2001 to December 2004 were analyzed retrospectively. Results： 750 oocytes were treated by ICSI; normal fertilization occurred in 530 oocytes, fertilization rate was 70. 67%; clinical pregnancies were achieved in 25 cases, clinical pregnancy rate was 33. 33%. The fertilization rate and cleavage rate were significantly higher in the second stage of 2003-2004 than that in the first stage of 2001-2002（68. 53% Vs 75. 86%, P〈0. 005; 89.19%Vs 95. 45%, P〈0. 01）. There was significant difference between three groups of different age in term of the rate of fertilization, implantation and clinical pregnancy. The fertilization rate was significantly lower in in vitro fertilization failure group. Conclusions ： ICSI technique should be the effective treatment for infertility. The quality of ooeyte, the female patient age and the ICSI technique do affect the outcome of ICSI treatment.