部分卵子单精子注射在体外受精中的必要性探讨

Analysis of results of intracytoplasmic sperm injection in fertilization in vitro

目的探讨在体外受精-胚胎移植（IVF-ET）中特殊情况下对部分卵子实行卵胞浆内单精子显微注射（Half ICSI）的必要性。方法回顾性分析2004年1月～2007年12月间在我院行Half ICSI的31个周期并将其作为研究组，将31个周期所有的卵子417个分为两个亚组，A组：行常规IVF-ET组214个卵子；B组：ICSI组203个卵子。分析两组受精率、卵裂率、优质胚胎获得率（优质胚胎彩卵子数），并且将同期在我院接受常规体外受精-胚胎移植（IVF-ET）连续427个周期及卵胞浆内单精子显微注射（ICSI）连续102个周期作为对照组。结果A组受精率、卵裂率及优质胚胎获得率显著低于B组，其中有7例完全不受精，11例受精率≤30％；研究组A组受精率、卵裂率、优质胚胎获得率明显低于对照组，但研究组（A组＋B组）妊娠率与对照组相比无显著性差异。结论在体外受精胚胎移植中如精子数量及质量在IVF—ET及ICSI指征的临界值之间或取卵日精液与术前检查不符等特殊情况，选择部分卵子行单精子显微注射可以有效地预防因完全不受精及受精率过低导致的无胚胎移植及妊娠率下降。

Objective To investigate the results of half intracytoplasmic sperm injection. （ Half ICSI） in in vitro fertilization - embryo transpalantation. Methods The clinical and laboratory data of 31 cases treated with Half ICSI for 31 cycles were anlayzed . The 417 oocytes were divided into 2 groups, group A consisted of 214 oocytes of intro fertilization, group B consisted of 203 oocytes with ICSI, while the control group consisted of 427 consecutive cycles of in vitro fertilization and 102 consecutive cycles of ICSI. Results The rates of insemination, cleavage and quality embryo in group A was lower than that of group B and control group significantly. The fertilization in 7 cases completely failed. , the insemination rate in 11 cases in group A was less than 30% and there no significant difference was obsrved in clinical gestational rate in the cases of group A compared to that of control group. Conclusion In special cases, Half ICSI can prevent fertilization failure and improve clinical gestational rate effectively.