常规体外受精-胚胎移植与卵胞浆内单精子注射临床效果比较

The comparation of clinic effects between routine IVF-ET and ICSI.

目的比较常规体外受精-胚胎移植(IVF-ET)与卵胞浆内单精子注射(ICSI)两种助孕技术的临床效果。方法本文将2002.01-2005.12就诊于本中心的198例患者进行了210个周期(IVF-ET 70个周期、ICSI 140个周期)的治疗。比较两组平均获卵数、正常受精卵数、卵裂数、胚胎移植数、临床妊娠率、流产率以及畸形胎儿情况。结果ICSI组平均每周期获卵数、正常受精卵数、卵裂数、胚胎移植数分别为8.06个、5.89个、5.72个、2.51个,而IVF-ET组分别为11.20个、8.76个、8.31个、2.10个。两组比较有统计学意义(P<0.05);ICSI组妊娠率35.71%(50/140)与IVF-ET组妊娠率37.14%(25/70)相近;ICSI组流产率30%(14/50)高于IVF-ET组流产率11.54%(3/25);ICSI组出生2个畸形儿而IVF-ET组此项为零。结论ICSI技术治疗严重男性因素引起的不育症可取得与常规IVF-ET治疗主要由女方不孕因素引起的不孕症相近的临床效果,但ICSI组流产率及畸形儿数均较IVF-ET组高。由此提示我们:应该更加严格掌握ICSI适应症。

To compare the clinic effect between the routine in vitro fertilization -embryo transfer （IVF- ET） and the intracytoplasmic sperm injection （ICSI） . Methods： 198 patients （210 cycles） were individed into two groups. One included 70 cycles who underwent IVF - ET, and the other included 140 cycles who underwent ICSI. The mean number of the oocytes retrieved , fer- tilized eggs, cleavages and embryos transferred were compared between the IVF - ET and the ICSI. Results： There were significant difference （ P 〈 0. 05 ） in the mean number of the oocytes retrieved （ 11.20 ± 5. 50 vers 8.06 ± 4. 97）, of the fertilized eggs （ 8.76 ± 5.56 vers 5.89 ± 4. 00）, of the cleavages （ 8.31 ± 4. 78 vers 5.72 ± 3. 74） and the mean number of the embryos transferred （ 2. 10 ± 0. 76 vers 2.51 -±0. 87） between the IVF - ET and the ICSI. The pregnancy rate was similarity in the IVF - ET （37. 14% 25/70） and ICSI （35.71% 50/140）, while the the abortion rate in the ICSI （30% 14/50 ） was higher than that in the IVF- ET （11.54% 3/25 ）, but the difference was no significant （ P 〉 0. 05 ）. There were 2 terata in the ICSI . Conclusion ： Similar clinical effects were accepted between the IVF - ET and the ICSI, although IVF - ET was used to treat the sterility from female and ICSI was used to treat the infertility from male. But the abortion rate and the number of teras in the ICSI were higher than that in the IVF - ET. So it is important to strictly master the indication in using ICSI.