单精子卵浆内注射应用于前周期常规体外受精失败和低受精的治疗结果

The clinical outcomes of ICSI in patients with previous fertilization failure or low fertilization rate after conventional IVF

目的:分析常规体外受精(IVF)完全受精失败和低受精随后周期行单精子卵胞浆内注射(ICSI)的临床结果。方法:2001年10月至2007年5月,30例IVF完全不受精和12例IVF低受精不育夫妇分别在随后周期采取38个周期(A组)和17个周期(B组)ICSI治疗,同期因男性因素行第1周期ICSI治疗的281个周期作为对照(C组),比较三组的正常受精率、优质胚胎率、胚胎种植率和临床妊娠率。结果:三组间正常受精率、优质胚胎率和临床妊娠率差异均无显著性;A组的胚胎种植率为14.3%,明显低于B组和C组(29.5%和26.0%,P均<0.05)。结论:IVF低受精患者在随后周期改行ICSI可获得理想的临床治疗效果,IVF完全受精失败患者随后周期改行ICSI的胚胎种植率较低,表明其完全受精失败至少部分原因是由于卵子异常而导致胚胎发育潜能的下降。

Objective： To analyze the clinical outcomes of ICSI in patients with previous fertilization failure or low fertilization rate after conventional IVF. Methods： From Oct. 2001 to May. 2007, 38 ICSI cases with previous total fertilization failure after conventional IVF were allocated to group A. 17 ICSI cases with previous low fertilization rate after conventional IVF were allocated to group B. And 281 ICSI cycles for male factor infertility in the same period were allocated to group C as control group. The fertilization rate, high quality embryo rate, implantation rate and clinical pregnancy rate of three groups were retrospectively analyzed. Results： There were no significant differences in fertilization rate, high quality embryo rate and clinical pregnancy rate among three groups, but implantation rate of group A （14.3%） was significantly lower than that of group B and C （29.5% and 26.0%）. Conclusion： For patients who have previous low fertilization rate after conventional IVF, ICSI is a good choice to improve clinical outcomes. But for patients who have previous total fertilization failure after conventional IVF, the implantation rate of ICSI embryos is lower than that of the others. It suggests fertilization failure be due at least partly to occyte abnormity,which results in the descent of embryo development potential.